Abstract:
With increasing concern about the negative health impact of fungal disease, there is a need to survey what is and is not known about the epidemiology of these infections in Tunisia. We have estimated the incidence and prevalence of the most serious fungal diseases in Tunisia for the first time. Using published literature from Tunisia, or if absent other countries, we have estimated the burden of life-threatening fungal infections and those causing significant morbidity, using deterministic modeling, based on populations at greatest risk. An estimated 250,494 (2.12% of the Tunisian population) are affected by a serious fungal disease annually. Invasive and chronic pulmonary aspergillosis are relatively common with 708 and 2090 patients affected, partly linked to the prevalence of chronic obstructive pulmonary disease (COPD). Fungal asthma (allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitization) have an estimated prevalence of 38,264 (5.8% of the adult asthma population). Fungal keratitis probably affects 1,761 eyes annually, often leading to uniocular blindness. Candidaemia and Candida peritonitis probably affect at least 680 people annually, with a high mortality. Recurrent vulvovaginal candidiasis probably affects over 200,000 women. While fungal diseases are regularly diagnosed in Tunisia, epidemiological studies with denominators are uncommon. Some fungal diseases are poorly addressed with the current diagnostic portfolio, and surveillance is lacking. Studies on these diseases and the implementation of a national program of surveillance are required.
摘要:
随着人们越来越关注真菌病对健康的负面影响,有必要调查突尼斯这些感染的流行病学情况。我们首次估计了突尼斯最严重真菌病的发病率和患病率。利用突尼斯出版的文献,或者如果不在其他国家,我们已经估计了危及生命的真菌感染和那些导致显著发病率的负担,使用确定性建模,基于风险最大的人群。估计每年有250,494人(占突尼斯人口的2.12%)受到严重真菌病的影响。侵袭性和慢性肺曲霉病相对常见,有708和2090名患者受影响,部分与慢性阻塞性肺疾病(COPD)的患病率有关。真菌性哮喘(过敏性支气管肺曲霉病和具有真菌致敏的严重哮喘)的患病率估计为38,264(占成年哮喘人群的5.8%)。真菌性角膜炎每年可能影响1,761只眼睛,经常导致单眼失明。念珠菌血症和念珠菌腹膜炎可能每年至少影响680人,死亡率很高。复发性外阴阴道念珠菌病可能影响200,000多名妇女。虽然真菌病在突尼斯经常被诊断出来,关于分母的流行病学研究并不常见。一些真菌病在目前的诊断组合中处理得很差,缺乏监控。需要对这些疾病进行研究并实施国家监测计划。