Study reveals huge extent of fungal disease in India

by University of Manchester

A) Published reports of histoplasmosis by state of residence of patients. B) Published reports of histoplasmosis according the authors’ institution, by state. Credit: Open Forum Infectious Diseases (2022). DOI: 10.1093/ofid/ofac603

Researchers from India and Manchester have shown that over fifty million Indians are affected by serious fungal disease, 10% of which are from potentially dangerous mold infections.

The experts from three Indian teaching hospitals: AIIMS, New Delhi, AIIMS Kalyani, West Bengal and PGIMER, Chandigarh, along with The University of Manchester, estimate that 57 million—or 4.4% of the 1.3 billion people who live in India—are likely to be affected.

The comprehensive review of data from over 400 published academic articles is published in the journal Open Forum Infectious Diseases.

The researchers found that vaginal thrush—or yeast infection—affected around 24 million women of reproductive age, with repeated attacks.

Hair fungal infection—known as tinea capitis—in school-age children affected a similar number. It causes a painful infected scalp and leaves many with hair loss.

Major contributors to death were mold infections affecting lungs and sinuses, affecting over 250,000 people. Another 1,738,400 people had chronic aspergillosis and there were 3.5 million with serious allergic lung mold disease.

Over 1 million are thought to have potentially blinding fungal eye disease, and nearly 200,000 had mucormycosis (so called “Black mold’).

Dr. Animesh Ray of AIIMS in Delhi, the lead author of the article, said, “The total burden due to fungal diseases is huge but underappreciated. While tuberculosis affects less than 3 million people in a year in India, the number of Indians affected by fungal disease are several times higher.”

Professor David Denning of The University of Manchester and Global Action For Fungal Disease added, “There have been major diagnostic improvements in recent years, with public health services in India catching up with private hospitals in terms of capability. However, fungal disease continues to be threat to public health and a cause of significant morbidity and mortality representing a considerable socioeconomic burden to those who are infected by them. And there remain large parts of India with limited diagnostic capability, as evidenced by our inability to estimate some important diseases such as histoplasmosis and fungal asthma in children.”