Know your fungal landscape in Vietnam

Professor Jeremy Day
Wellcome Trust Intermediate Fellow
Head, CNS & HIV Infections Research Group
Oxford University Clinical Research Unit
Ho Chi Minh City, Vietnam

There are an estimated 2 million life-threatening infections due to invasive fungal infections every year, and more than 90% of these are due to 4 species – Candida, Cryptococcus, Aspergillus and Pneumocystis.¹ Immunosuppression and co-morbidities play a significant role in the risk of developing these infections. In Vietnam, tuberculosis, HIV infection, and air pollution are key drivers for fungal infections. A study to estimate the burden of fungal infection in Vietnam offered new insights into the prevalence of AIDS-associated mycoses, aspergillosis and candidiasis.² In the study, the authors used an actuarial approach to estimate the prevalence of fungal diseases based on the population structure of Vietnam, available incidence and prevalence data from literature.²

The estimated incidence and prevalence of selected fungal infections seemed to be lower compared to several countries; Professor Day noted that the numbers may be underestimated due to a lack of high quality data.^2-5 If anything, this study raised more questions about the large unrecognized burden of disease, which warranted further epidemiological research.

Clinical pearls

• Fungal infections are a growing concern in Vietnam
• Possible causes include more sophisticated medical treatment and increased pollution
• There is an urgent need to improve fungal diagnostics and fungal infection reporting in Vietnam

Figure 1. Incidence and prevalence of selected invasive mycoses, selected countries^2-5

ABPA, allergic bronchopulmonary aspergillosis; SAFS, severe asthma with fungal sensitization; CPA, chronic pulmonary aspergillosis.

Highlights of the Medical Mycology Training Network Conference, December 1–3, 2017, Ho Chi Minh City, Vietnam

References

1. Brown GD, et al. Sci Transl Med 2012;4:165rv13.
2. Beardsley J, et al. Mycoses 2015;58:101-106.
3. Rodriguez-Tudela JL, et al. Clin Microbiol Infect 2015;21:183-189.
4. Dorgan E, et al. J Med Microbiol 2015;64:423-426.