Each year, more than 80 million people are at a high risk of either succumbing to a fungal disease or experiencing vision loss. Approximately 6.55 million patients develop life-threatening fungal infections annually, of which 3.75 million unfortunately do not survive. It’s important to note that these estimates are based on the demographics of underlying conditions (such as HIV infection, leukemia and lymphoma, lung cancer, intensive care, pulmonary tuberculosis, COPD and severe asthma) because there is currently no global access to the diagnosis of fungal diseases worldwide, and surveillance programs are limited. As a result, these numbers are approximations.
However, when prospective studies have been conducted, especially in people living with HIV, they consistently reveal a higher burden of fungal infections than previously estimated. This underscores the critical need for improved access to diagnosis and treatment to reduce the suffering and mortality caused by fungal diseases on a global scale.
Some fungal diseases are acute and severe (i.e., cryptococcal meningitis and fungal eye infection (keratitis), other recurrent (i.e., Candida vaginitis or oral candidiasis in AIDS) and other chronic (i.e., chronic pulmonary aspergillosis or fungal hair infection (tinea capitis)). The most common life-threatening fungal infections and estimated overall mortality are shown below.
(ABPA, allergic bronchopulmonary aspergillosis; AIDS, acquired immunodeficiency syndrome; COPD, chronic obstructive pulmonary disease; ICU, intensive care Unit; TB, tuberculosis; Transplant, Solid organ transplantation)
Fungal disease |
Number affected (annual incidence) |
Case fatality rate |
Estimated deaths (crude mortality) |
Comments |
| Cryptococcal meningitis | 194,000 in AIDS and non-AIDS | 15-20% USA >50% developing world |
147,000 | 79% in AIDS |
| Pneumocystis pneumonia | 400,000 in AIDS 105,000 in non-AIDS |
~15% in AIDS with best treatment ~40% in non-AIDS |
140,000 in AIDS 74,000 non-AIDS |
Global pathogen, often treated empirically |
| Disseminated histoplasmosis in AIDS | 71,000 | 30%, if diagnosed and treated | 66,000 | Globally present, but data from Africa and SE Asia scanty |
| Invasive aspergillosis | 2,100,000:
27,000 in leukaemia/lymphoma 1,513 in COPD admissions to hospital 519,000 in intensive care 57,000 in lung cancer |
~30% mortality in leukaemia in HIC
~45-70% in COPD ~30% mortality if treated in HIC |
1,800,000
|
Many missed diagnoses globally |
| Candidaemia and invasive candidiasis | 1,565,000 | 35% mortality treated | 995,000 | Uncertainty about incidence and deaths from patients without a positive blood culture |
| Chronic pulmonary aspergillosis | 1,837,000 | 8% mortality in HIC | 340,000 in non hospitalised populations | Under-diagnosed and mistaken for tuberculosis. Annual prevalence much higher |
| Coccidioidomycosis | 30,000 | (no mortality rate so -) | 2,000 (deaths) | Most cases occur in USA andMexico |
| Fungal asthma | 11,500,000* | <1% but no good figures. | At least 46,000 deaths | Much uncertainty about prevalence and contribution to death |
| Fungal keratitis | 1-0-1,4 million | Blinding >60% | >600,000 blind eyes | Diagnosis often late |
| Total | ~13,500,000 | >1,600,000 | Probably a significant underestimate |
