Key recent contributions to the academic literature

David Denning, 2024  Lancet Inf. Dis. Global incidence and mortality of severe fungal disease. New estimates of the annual incidence of severe fungal infections show about 6.5 million affected, leading to 3.7 million deaths every year, as opposed to the previously estimated 1.5-2.0 million per year. Supplementary data: Supplement 1, Supplement 2 Candida PCP ratesSupplement 3 Mortality calculator.

Narda Medina and colleagues use their experience in Guatemala to show how an active role of laboratories can improve patients’ survival, principally using non-culture-based assays which improve accuracy and turnaround time. Diagnostic packages for opportunistic infections can overcome many deficiencies caused by the absence of awareness. J Fungi 2022

The WHO lists multiple fungal pathogens of critical, high and medium importance for addressing with R&D, surveillance and access to diagnosis and treatment. October 2022.

Lottie Brown et.al, 2022 The Case for Fungal Keratitis to Be Accepted as a Neglected Tropical Disease (Review) J Fungi.

Radha Rajasingham, 2022. The global burden of HIV-associated cryptococcal infection in adults in 2020: a modelling analysis. Lancet Infectious Diseases. Supplementary data.

Daniel Wagner C. L. Santos 2021. The global burden of chromoblastomycosis PLoS Negl Trop Dis. Supplementary data.

Lottie Brown, 2020. The global incidence and diagnosis of fungal keratitis Lancet Infectious Diseases. Supplementary data.

Emily Hammond and Charles McDonald, 2020.  The global impact of Aspergillus infection on COPD with estimates of COPD prevalence, annual hospitalisations and invasive aspergillosis incidence. BMC Pulm Med 2020. Supplementary data.

Darcy Emery 2020. In The global distribution of actinomycetoma and eumycetoma has updated global maps of mycetoma and separated Actinomycetoma from Eumycetoma PLoS NTD.  Supplementary data.

Nida Ashraf et.al 2020. Re-drawing the global maps of histoplasmosis, blastomycosis and coccidioidomycosis, Mycopathologia.

Jacob Baker, et.al. 2019. New maps of histoplasmosis in South East Asia – implications for diagnosis in AIDS, Emerging Microbes & Infections. Supplementary material Figure S1 Revised

While 70% of women have vulvovaginal candidiasis (thrush or yeast infection) at least once in their lifetime, 138 million suffer recurrent episodes in any one year and at least 372 million at some point in their lives. Lancet Infect Dis 2018. View the burden of disease map.

In July 2017 the WHO published guidelines for managing advanced HIV disease and rapid initiation of anti-retroviral therapy.
WHO HIV summary      WHO HIV full guidelines

Dr Radha Rajasingham: Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis in Lancet ID May 2017

Control of antimicrobial resistance (AMR) will require access to as well as better and faster fungal infection diagnostics, as argued by GAFFI’s Senior Advisors in Emerging Infectious Diseases (2017).

David Denning has recently published an Editorial calling upon all public health mycologists

Matthew Kneale et al published data that shows that millions of people worldwide are deprived access to antifungal medicines that are widely available elsewhere. “Global access to antifungal therapy and it’s variable cost” was published in August 2016.

David Denning constructed scenarios to estimate avoidable deaths from 2016 to 2020 and showed that 550 AIDS patients can be saved every day by detecting and treating fungal infections.

David Denning:  Roadmap for the diagnosis and management of fungal disease in Thorax 2015 

Joanne Armstead estimate the “Different manifestations of aspergillosis in cystic fibrosis adults in 30 countries”

Darius Armstrong- James et al describe “A neglected epidemic: fungal infections in HIV/AIDS” in Trends in Microbiology March 2014

Angela Loyse et al found that in most subsaharan countries flucytosine is not registered and unavailable, and while amphotericin B is registered in about 50% of the countries, it is not available in most, depriving these populations of the best drugs for the very common cryptococcal meningitis.

Jeremy Day et al convincingly demonstrated that the combination of flucytosine and amphotericin B significantly reduced mortality in cryptococcal meningitis in AIDS

Gordon Brown et al summarized the current status of fungal diseases in Science Translational Medicine in December 2012

Adenis et al published a modelling study that concluded disseminated histoplasmosis in AIDS is more common than TB in AIDS in Latin America. An estimated 22,600 infected, with 6710 to 15 657 cases of symptomatic HIV-associated histoplasmosis and 6,710 deaths (2018, Lancet Infectious Diseases). Appendices.

Over 138 million women are affected by recurrent vulvovaginal candidiasis (thrush or yeast infection) across the world according to a recently published paper in Lancet Infectious Diseases, by David Denning and colleagues. Appendix


WHO report: Fungal pathogen Priority List

O’Neill report: Antimicrobials in Agriculture & the Environment

O’Neill report: Rapid Diagnostics & Stopping Unecessary Use of Antibiotics 

WHO report: Universal Eye Health – A global action plan 2014-2019

ECDC report: Risk assessment on the impact of environmental usage of triazoles on the development and spread of resistance to medical triazoles in Aspergillus species

WHO report: Neglected tropical diseases.: Mycetoma

Consensus on the approach to the diagnosis of chronic pulmonary aspergillosis in low and middle-income countries (LMICs) would benefit from confirmation in clinical studies – see meeting report in Emerging Infectious Diseases 2018.

Access to diagnosis

Makarangara Diagnostic capacity fungal keratitis Africa Ocular Surface 2023

Mushi Diagnostic options for lung fungal disease in Africa ERJ Open Res 2023

Salmanton-Garcia Laboratory survey in Asia Int J Antimicrob Ag 2023

Salmonton-Garcia European Diagnostic Survey Lancet Microbe 2023

Tufa WHO diagnostics for IFIs in cancer ICU Africa J Pub Health Infect 2023

Badiane Diagnostic capacity Africa Int J Dermatology 2023

Driemeyer Clinical mycology eastern Europe Med Mycol 2022

Driemeyer Mycology in Africa ECMM ISHAM Lancet Infect Dis 2022

Falci Pasqualotto Latin American lab capacity Mycoses 2019

Chindamporn Survey of Laboratory Practices in Asia Med Mycol 2018