Estimated Incidence and Prevalence of Serious Fungal Infections in Morocco

Abstract

Few data are published from Morocco on fungal disease, although numerous case reports attest to a wide range of conditions in the country. Here, we estimate for the first time the incidence and prevalence of serious fungal diseases in the country. Detailed literature searches in English and French were conducted for all serious fungal infections. Demographic and individual underlying condition prevalence or annual incidence were obtained from UNAIDS (HIV), WHO (TB) and other international sources. Deterministic modelling was then applied to estimate fungal disease burden. Morocco’s population in 2021 was 36,561,800. Multiple publications describe various fungal diseases, but epidemiological studies are rare. The most frequent serious fungal infections were tinea capitis (7258/100,000) and recurrent vulvovaginal candidiasis (2794/100,000 females). Chronic pulmonary aspergillosis is also common at a prevalence of 19,290 (53/100,000) because of the relatively high rate of tuberculosis. The prevalence of asthma in adults exceeds one million, of whom fungal asthma (including allergic bronchopulmonary aspergillosis (ABPA)) probably affects 42,150 (115/100,000). Data are scant on candidaemia (estimated at 5/100,000), invasive aspergillosis (estimated at 4.1/100,000), HIV-related complications such as cryptococcal meningitis and Pneumocystis pneumonia and mucormycosis. Fungal keratitis is estimated at 14/100,000). Mycetoma and chromoblastomycosis are probably rare. Fungal disease is probably common in Morocco and diagnostic capacity is good in the teaching hospitals. These estimates need confirmation with methodologically robust epidemiological studies.

Invasive Fungal Diseases in Africa: A Critical Literature Review

“…The burden of CM in some African countries has been estimated over the years, with the lowest rate in Algeria (35 cases/year) and the highest in Nigeria (57,866 cases/year) [30]. These estimates are based on studies carried out in these countries and usually in HIV-positive patients with low CD4 count [6,[31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] (Table 1). The availability of studies and data on cryptococcal antigenemia and CM varies from one country to the other (Table 2).…”

Assessing Diagnosis of Candida Infections: A Study on Species Prevalence and Antifungal Resistance in Northern Morocco

“…Morocco bears a high burden of globally significant fungal diseases but has lagged behind in epidemiological data collection and reporting. Only few epidemiological data on fungal infections, including candidiasis, are documented in the country [ 7 ]. Recently, the World Health Organization (WHO) released a list of fungal priority pathogens in which two Candida species ( C. albicans and C. auris ) are considered in the critical priority group, and three others, C. glabrata , C. parapsilosis, and C. tropicalis , are in the high priority group [ 1 ].…”

“…The Global Action For Fungal Infections (GAFFI) recently estimated that 3,300,000 persons in Morocco (9% of the population) suffer from a fungal infection each year [ 7 ]. Moreover, recurrent vulvovaginal candidiasis is considered as the second most frequent fungal infection in the country, with an incidence rate of 2794 per 100,000 females.…”

Aspergillus fumigatus identification and antibiotic sensitivity in Iraqi patients

“…There are very few data on the burden of fungal diseases, unlike many of the Arab League countries (21). it had estimated the incidence and prevalence of the most serious fungal diseases using national, regional and international data in specific populations at risk (22). Differences in sex have a determining influence on the prevalence and incidence of many infectious diseases, including infections caused by bacteria, viruses, parasites and fungi (23).…”