Epidemiology of cryptococcosis in Malaysia

Abstract

This study describes the isolation of Cryptococcus neoformans and Cryptococcus gattii from patients with chronic meningitis who were admitted to 16 Malaysian hospitals, from 2003 to 2004. Of the 96 cryptococcal cases reported over the 2-year period, 74 (77.1%) patients were male and 45 (46.9%) patients were between 30 and 39 years old. Cryptococcosis was uncommon in children. A total of 57 (59.4%) and 23 (24.0%) patients were Malay and Chinese respectively. Human immunodeficiency virus infection was the major underlying disease reported in 36 (37.5%) patients. C. neoformans var. grubii (serotype A and molecular type VNI) was the predominant Cryptococcus species isolated from 88.5% of cryptococcal cases in this country. Cryptococcal cases due to C. neoformans var. grubii were reported from all the five regions in Malaysia, with the most number of cases reported from the central and northern regions. Cryptococcus gattii (all were serotype B and molecular types VGI/II) was isolated from all regions except the southern region. Compared with a study conducted prior to the AIDS era, our findings show substantial changes in the demographical characteristics of patients.

A retrospective study of contributing factors for prognosis and survival length of cryptococcal meningoencephalitis in Southern part of China (1998–2013)

“…Although CM may affect people of any age [17], neonates, children and the elderly were not the predilection in our study, mostly because of their limited environmental exposure. In accordance with other studies [12], male predominance (71.30%) was apparent in this study, the reason of which was not fully understood, but can be due to increased environmental exposure, hormonal effect and/or genetic predisposition [3]. …”

“…Dramatically lower than in Malaysia (37.5%) [12], Europe (68%) [7] and United States (89%) [4], 2 cases (1.85%) were HIV positive in CM patients in our study. Nevertheless, chronic use of corticosteroids or other immunosuppressants (17.59%) was the most common risk factor in Chinese CM patients, probably as a result of the increasing morbidity of autoimmune disease and less attention of side effects of such drugs from patients and care givers.…”

“…Unlike data collected from North America [9,10], South America [7,8], Europe [11] and other countries in Asia [5,6,12], the incidence of cryptococcosis in immunocompetent patients is high in China. Chen et al [1] had summarized some features of cryptococcosis in China, but their focus was towards therapy.…”

Prevalence of cryptococcosis among HIV-infected patients in Yaounde, Cameroon

“…This may reflect the difference of exposure rather than difference in host susceptibility 5,6 . According to some authors, the reason for male predominance is not known although increased environmental exposure, hormonal inûuences and D or genetic predisposition of the patients have been postulated to be the contributing factors 7,8 . The age ranges in C. neoformans-positive patients (26 -45 years) obtained in this study fit in with findings from previous studies.…”

Global Molecular Epidemiology ofCryptococcus neoformansandCryptococcus gattii: An Atlas of the Molecular Types

“…Geographic distribution of the molecular types identified in Asia (c). Molecular typing data have been combined from the following references: India [11, 14, 15, 28–36], China [8, 37–43], Thailand [11, 15, 44–48], Malaysia [49, 50], Vietnam [51], Taiwan [38, 52], Japan [38, 53, 54], Republic of Korea [55], and Israel [56]. …”