Endemic mycoses in South Africa, 2010-2020: A decade-long description of laboratory-diagnosed cases and prospects for the future.
Background Emergomycosis, histoplasmosis, sporotrichosis and blastomycosis are endemic to southern Africa; the first two are AIDS-related mycoses. We described laboratory-diagnosed cases of endemic and imported mycoses in South Africa over a decade and discuss available diagnostic tools, reasons for...
Published in: | PLOS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2022
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0010737 https://doaj.org/article/e00e529ac68f4df18402d26c04229208 |
id |
ftdoajarticles:oai:doaj.org/article:e00e529ac68f4df18402d26c04229208 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:e00e529ac68f4df18402d26c04229208 2023-05-15T15:13:27+02:00 Endemic mycoses in South Africa, 2010-2020: A decade-long description of laboratory-diagnosed cases and prospects for the future. Rutendo E Mapengo Tsidiso G Maphanga Wayne Grayson Nelesh P Govender 2022-09-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0010737 https://doaj.org/article/e00e529ac68f4df18402d26c04229208 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0010737 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010737 https://doaj.org/article/e00e529ac68f4df18402d26c04229208 PLoS Neglected Tropical Diseases, Vol 16, Iss 9, p e0010737 (2022) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2022 ftdoajarticles https://doi.org/10.1371/journal.pntd.0010737 2022-12-30T19:53:02Z Background Emergomycosis, histoplasmosis, sporotrichosis and blastomycosis are endemic to southern Africa; the first two are AIDS-related mycoses. We described laboratory-diagnosed cases of endemic and imported mycoses in South Africa over a decade and discuss available diagnostic tools, reasons for the current under-estimation of cases and future strategies to improve case ascertainment. Materials and methods We analysed electronic pathology laboratory data from all public laboratories and one large private laboratory in South Africa from 2010-2020. Diagnostic specimens processed at the national mycology reference laboratory were also included. We classified cases as proven, probable and possible based on the method of identification. Results We identified 682 cases, of which 307 were proven, 279 were probable and 96 were possible. Of 307 culture-confirmed cases, 168 were identified by phenotypic methods plus sequencing, 128 by phenotypic methods alone and 11 by direct PCR. Of 279 probable cases, 176 had yeasts observed on histology, 100 had a positive Histoplasma antigen test and 3 a positive pan-dimorphic PCR test. All 96 possible cases had compatible clinical syndrome with inflammatory infiltrates on skin tissue histology. A majority of cases had an unspecified endemic mycosis (207/682, 30.4%), followed by sporotrichosis (170/682, 24.9%), emergomycosis (154/682, 22.6%), histoplasmosis (133/682, 19.5%), blastomycosis (14/682, 2.1%) and talaromycosis (4/682, 0.6%). Conclusions This study reports a relatively low number of cases over a decade considering an estimated large population at risk, suggesting that a substantial fraction of cases may remain undiagnosed. There is a need to increase awareness among healthcare workers and to develop rapid point-of-care diagnostic tools and make these widely accessible. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Rapid Point ENVELOPE(-97.552,-97.552,75.868,75.868) PLOS Neglected Tropical Diseases 16 9 e0010737 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Rutendo E Mapengo Tsidiso G Maphanga Wayne Grayson Nelesh P Govender Endemic mycoses in South Africa, 2010-2020: A decade-long description of laboratory-diagnosed cases and prospects for the future. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Emergomycosis, histoplasmosis, sporotrichosis and blastomycosis are endemic to southern Africa; the first two are AIDS-related mycoses. We described laboratory-diagnosed cases of endemic and imported mycoses in South Africa over a decade and discuss available diagnostic tools, reasons for the current under-estimation of cases and future strategies to improve case ascertainment. Materials and methods We analysed electronic pathology laboratory data from all public laboratories and one large private laboratory in South Africa from 2010-2020. Diagnostic specimens processed at the national mycology reference laboratory were also included. We classified cases as proven, probable and possible based on the method of identification. Results We identified 682 cases, of which 307 were proven, 279 were probable and 96 were possible. Of 307 culture-confirmed cases, 168 were identified by phenotypic methods plus sequencing, 128 by phenotypic methods alone and 11 by direct PCR. Of 279 probable cases, 176 had yeasts observed on histology, 100 had a positive Histoplasma antigen test and 3 a positive pan-dimorphic PCR test. All 96 possible cases had compatible clinical syndrome with inflammatory infiltrates on skin tissue histology. A majority of cases had an unspecified endemic mycosis (207/682, 30.4%), followed by sporotrichosis (170/682, 24.9%), emergomycosis (154/682, 22.6%), histoplasmosis (133/682, 19.5%), blastomycosis (14/682, 2.1%) and talaromycosis (4/682, 0.6%). Conclusions This study reports a relatively low number of cases over a decade considering an estimated large population at risk, suggesting that a substantial fraction of cases may remain undiagnosed. There is a need to increase awareness among healthcare workers and to develop rapid point-of-care diagnostic tools and make these widely accessible. |
format |
Article in Journal/Newspaper |
author |
Rutendo E Mapengo Tsidiso G Maphanga Wayne Grayson Nelesh P Govender |
author_facet |
Rutendo E Mapengo Tsidiso G Maphanga Wayne Grayson Nelesh P Govender |
author_sort |
Rutendo E Mapengo |
title |
Endemic mycoses in South Africa, 2010-2020: A decade-long description of laboratory-diagnosed cases and prospects for the future. |
title_short |
Endemic mycoses in South Africa, 2010-2020: A decade-long description of laboratory-diagnosed cases and prospects for the future. |
title_full |
Endemic mycoses in South Africa, 2010-2020: A decade-long description of laboratory-diagnosed cases and prospects for the future. |
title_fullStr |
Endemic mycoses in South Africa, 2010-2020: A decade-long description of laboratory-diagnosed cases and prospects for the future. |
title_full_unstemmed |
Endemic mycoses in South Africa, 2010-2020: A decade-long description of laboratory-diagnosed cases and prospects for the future. |
title_sort |
endemic mycoses in south africa, 2010-2020: a decade-long description of laboratory-diagnosed cases and prospects for the future. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2022 |
url |
https://doi.org/10.1371/journal.pntd.0010737 https://doaj.org/article/e00e529ac68f4df18402d26c04229208 |
long_lat |
ENVELOPE(-97.552,-97.552,75.868,75.868) |
geographic |
Arctic Rapid Point |
geographic_facet |
Arctic Rapid Point |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 16, Iss 9, p e0010737 (2022) |
op_relation |
https://doi.org/10.1371/journal.pntd.0010737 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010737 https://doaj.org/article/e00e529ac68f4df18402d26c04229208 |
op_doi |
https://doi.org/10.1371/journal.pntd.0010737 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
16 |
container_issue |
9 |
container_start_page |
e0010737 |
_version_ |
1766344013675233280 |