Fungal infections in Algeria.

ABSTRACT

INTRODUCTION: Invasive and superficial fungal infections are increasingly reported in Algeria, testifying to the increase in their frequency in parallel with the increase in risk factors and the availability of diagnostic means, at least in university hospitals (CHU). The latter, located in the major northern cities, are equipped with high-performance diagnostic tools compared to hospitals in the interior of the country. METHODS: A comprehensive search of published and grey literature was undertaken. Prevalence and incidence of discrete fungal diseases were estimated using a deterministic modelling approach based on populations at risk. Population (2021) and major underlying disease risk groups were obtained from UNAIDS, WHO Tuberculosis and the international transplant registries as well as published data for asthma and COPD. The health service profile was summarised from national documentation. RESULTS: Among the 43.6 million, including 12.9 million children, living in Algeria, the most prevalent fungal diseases are tinea capitis (>1.5 million), recurrent vaginal candidiasis (>500,000) and allergic fungal lung and sinus disorders (>110,000) and chronic pulmonary aspergillosis (>10,000). Life-threatening invasive fungal infection incidence includes 774 Pneumocystis pneumonia in AIDS, 361 cryptococcal meningitis, 2272 candidaemia and 2639 invasive aspergillosis cases. Fungal keratitis probably affects >6000 eyes each year. CONCLUSIONS: Fungal infections are underestimated in Algeria because they are sought in patients with risk factors only after bacterial infections when they should be sought in parallel. The diagnosis is only accessible in hospitals in large cities and the work carried out in mycology is rarely published, making the estimation of the burden of these conditions difficult.