Mucormycosis in Africa: Epidemiology, diagnosis and treatment outcomes
- 7 March 2023
- Vol. 66 (7), 555-562
- https://doi.org/10.1111/myc.13581
Abstract
Mucorales fungi cause mucormycosis, an invasive and rapidly progressive disease which increasingly affects mostly immunocompromised but also immunocompetent individuals. The objective of this study was to highlight the epidemiology, diagnostic modalities, treatment and overall survival of mucormycosis in Africa. We searched for relevant publications in PubMed, Google Scholar and African Journal Online databases covering the period 1960-2022. A total of 147 articles were identified, of which 66 were included in the review, detailing 408 individual cases from 12 African countries; 330 (80.9%) from North Africa, 63 (15.4%) from Southern Africa, seven (1.7%) from East Africa, seven (1.7%) from West Africa and a single case (0.2%) from Central Africa. The most frequently described clinical forms were rhino-orbital-cerebral (n = 307, 75.2%) and gastrointestinal (n = 51, 12.5%). Diabetes mellitus, COVID-19, malignancies and neutropaenia were the commonest underlying risks in 203 (49.8%), 101 (24.8%), 65 (15.9%) and 53 (13.0%) cases respectively. Most cases, 296 (72.5%) were diagnosed by histopathology. Fungal aetiology was identified in 38 (9.3%), of which the commonest was Rhizopus oryzae/arrhizus (27/38, 71.1%). Of the 408 cases, 334 (81.9%) patients received antifungal therapy, while 244 (59.8%) had surgery. In cases with a specified outcome, survival rate was 59.1% (228/386). Based on case reporting, a substantial burden of mucormycosis occurs in North Africa but the disease is rarely reported in most of the sub-Saharan region. Establishing a comprehensive registry for standardised data collection could improve understanding of the epidemiology of mucormycosis in the region.Keywords
This publication has 26 references indexed in Scilit:
- Diabetes mellitus as the major risk factor for mucormycosis in Mexico: Epidemiology, diagnosis, and outcomes of reported casesMedical Mycology, 2017
- Epidemiology of and Risk Factors for Type 2 Diabetes in EgyptAnnals of Global Health, 2016
- Epidemiology of mucormycosis in EuropeClinical Microbiology & Infection, 2014
- Epidemiology and Clinical Manifestations of MucormycosisClinical Infectious Diseases, 2012
- A Global Analysis of Mucormycosis in France: The RetroZygo Study (2005-2007)Clinical Infectious Diseases, 2012
- Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007Clinical Microbiology & Infection, 2011
- Epidemiology and treatment approaches in management of invasive fungal infectionsClinical Epidemiology, 2011
- A higher-level phylogenetic classification of the FungiMycological Research, 2007
- The rising trend of invasive zygomycosis in patients with uncontrolled diabetes mellitusMedical Mycology, 2006
- Epidemiology and Outcome of Zygomycosis: A Review of 929 Reported CasesClinical Infectious Diseases, 2005