Estimation of the Burden of Serious Human Fungal Infections in Malaysia

Abstract

Fungal infections (mycoses) are likely to occur more frequently as ever-increasingly sophisticated healthcare systems create greater risk factors. There is a paucity of systematic data on the incidence and prevalence of human fungal infections in Malaysia. We conducted a comprehensive study to estimate the burden of serious fungal infections in Malaysia. Our study showed that recurrent vaginal candidiasis (>4 episodes/year) was the most common of all cases with a diagnosis of candidiasis (n = 501,138). Oesophageal candidiasis (n = 5850) was most predominant among individuals with HIV infection. Candidemia incidence (n = 1533) was estimated in hospitalized individuals, some receiving treatment for cancer (n = 1073), and was detected also in individuals admitted to intensive care units (ICU) (n = 460). In adults with asthma, allergic bronchopulmonary aspergillosis (ABPA) was the second most common respiratory mycoses noticed (n = 30,062) along with severe asthma with fungal sensitization (n = 39,628). Invasive aspergillosis was estimated in 184 cases undergoing anti-cancer treatment and 834 ICU cases. Cryptococcal meningitis was diagnosed in 700 subjects with HIV/AIDS and Pneumocystis jirovecii pneumonitis (PCP) in 1286 subjects with underlying HIV disease. The present study indicates that at least 590,214 of the Malaysian population (1.93%) is affected by a serious fungal infection annually. This problem is serious enough to warrant the further epidemiological studies to estimate the burden of human fungal infections in Malaysia.

Estimated burden of serious human fungal diseases in Turkey

“…Based on the assumption that 22.3% of microbial keratitis are due to fungi, we estimated the incidence of fungal keratitis in Turkey at 33 per 100 000 population annually, which suggests fungal keratitis is a particular problem in Turkey. This estimate is more than expected number of cases in Italy (0.94/100 000), Malaysia (1.3/100 000) and Egypt (14/100 000) and less than Pakistan (44/100 000) and Nepal (73/100 000) …”

Mapping histoplasmosis in South East Asia – implications for diagnosis in AIDS

“…Because of these studies, which are lacking in other South East Asian countries, higher numbers of cases reported in Thailand and Malaysia may in part be due to increased levels of clinical awareness rather than an actual increased prevalence of the disease in those places. In Thailand and Malaysia, the HIV-associated burden of histoplasmosis has been calculated at 184 and 175 for Thailand [44] and Malaysia [45] respectively, indicative of major under-reporting of cases. These studies demonstrated the potentially high mortality of histoplasmosis in AIDS; for example Wongprommek reported a survival rate at 6- and 12-month of 88% and 75%, respectively, out of 57 cases, not all HIV positive [42].…”

Fungal Diseases in Taiwan—National Insurance Data and Estimation

“…There are few studies reporting the nationwide burden of candidemia in Asia. In Malaysia and Vietnam, it was estimated to be five per 100,000 population, without any direct data to support these estimates [12,13].…”