There are several diseases which can affect the human body. Most of which can be undetectable for an extended period. Fungal infections can affect anyone and appear in any body part.
According to medical experts in Nigeria, 11.8 per cent of Nigerians suffer from invasive fungal infections each year.
According to the experts, who spoke at the Nigeria Centre for Disease Control’s fungal disease surveillance stakeholders meeting, invasive fungal infections are life-threatening. They can lead to death if left undiagnosed and untreated.
Invasive fungal infections frequently affect critically ill patients and those with significant underlying immune system-related conditions. Those at high risk of invasive fungal infections include those with cancer, HIV/AIDS, organ transplants, chronic respiratory disease, and post-primary tuberculosis infection.
Invasive fungal infections are those in which fungi have infiltrated deep tissues and established themselves, resulting in a prolonged illness.
Rita Oladele, an Associate Professor at the University of Lagos and Head of Medical Microbiology and Parasitology at UNILAG and Lagos University Teaching Hospital, said in a meeting that despite the high morbidity and mortality associated with fungal diseases, they are under-recognized in Nigeria.
According to her, there is no mycology laboratory in Nigeria, and only four antifungal agents are registered.
On the other hand, she stated an urgent need for capacity building to fight against fungal infections.
“There is a need to establish a surveillance system, simultaneous integration of fungal disease into the training of the health workforce. At least three reference mycology laboratories must be established for training and diagnosing these serious life-threatening infections. There is a need for antifungal diseases in existing health programmes in the country.”
“From research, if you delay starting treatment for things like invasive candidiasis and invasive aspergillosis, there’s a 20 per cent chance that the person will die. If you miss the diagnosis for five days, it’s invariably that the patient will die.”
“We must make this diagnosis early. Unfortunately, the doctors do not suspect it, and the laboratories do not have the facilities to diagnose, so people are dying needlessly.”
“Some of the patients you think have tuberculosis and on treatment could be having fungal disease, and it is when we do the right test that we will be able to do. TB patients will cough the same way as patients with chronic aspergillosis or histoplasmosis.”
“So, you need to be able to do the test to know what is wrong,” she said.
According to Dr Tochi Okwor, the National Antimicrobial Resistance Programme Coordinator, invasive fungal infections are life-threatening diseases with significant morbidity and mortality.
She said, “Some drugs to treat these diseases are not routinely accessible and affordable. Two of these infections, if not promptly diagnosed, result in an over 70 per cent mortality rate. In 2014, an estimate of serious fungal infections in the country was done. It revealed that over 960,000 Nigerians are estimated to be affected with substantial mortality. A survey of doctors in Nigeria in the same year showed that only 2 (0.002 per cent) out of 1,046 doctors had good awareness and knowledge of invasive fungal diseases.
“However, a significant number of Nigerian patients are at risk of developing these diseases, with the major risk factors being HIV, diabetes, long-term use of steroids, tuberculosis, cancers, old age, new-born (especially low birth weight babies), and generally people that have some form of immunosuppression.
“There is the additional challenge of some of these disease-causing fungi now being resistant to the readily available antifungal drugs. There have been documented reports of outbreaks of Candida Auris (a multi-drug resistant organism) in various countries. In 2022, we documented an outbreak in Nigeria, which is still ongoing. Mucormycosis (the black mould), a major scare in India during the peak of the COVID-19 pandemic, has also been documented amongst Nigerian patients. One of the drugs to manage this condition is not yet registered in Nigeria,” Dr Okwor noted.
The World Health Organization released a report highlighting the first-ever list of fungal priority pathogens – a catalogue of the 19 fungi that pose the greatest threat to public health.
The WHO list of fungal priority pathogens is the first global effort to systematically prioritize fungal pathogens, taking into account unmet research and development needs and perceived public health importance.
The WHO FPPL seeks to focus and drive additional research and policy interventions to strengthen the global response to fungal infections and antifungal resistance.
According to the WHO, “fungal pathogens are a major threat to public health as they become more common and resistant to treatment, with only four classes of antifungal medicines currently available and few candidates in the clinical pipeline.” Most fungal pathogens do not have rapid and sensitive diagnostics, and those that exist are not widely available or affordable globally.”