Risk-Based Estimate of Human Fungal Disease Burden, China
Ling‐Hong Zhou, Ying‐Kui Jiang, Ruoyu Li, Liping Huang, Ching‐Wan Yip, David W. Denning, Liping Zhu
Abstract
F ungal diseases constitute a growing problem worldwide, causing a large, but poorly quantified, impact on public health (1). The incidence of fungal infections varies according to geographic region, socioeconomic conditions, and the number of persons with underlying conditions. China is one of the largest countries in the world (largest population and third largest land area). It has almost every type of weather niche, from the Pacific coast in the south to the snowy mountains in the Qinghai-Tibet Plateau, and even tropical rain forest. Many endemic fungal infections are present in China, along with globally distributed fungal pathogens. Although China has become the world's second largest economy, it is still a developing country, with millions of impoverished citizens who are susceptible to fungal infections. Fungal keratitis, one of the major causes of avoidable blindness, has been relatively neglected (2). Moreover, old pathogens such as Histoplasma and Talaromyces marneffei (talaromycosis) have expanded (3,4); new hosts contributing to new therapies for malignant and autoimmune disease have increased (5,6); and new patterns, including aspergillosis in pulmonary tuberculosis (PTB) and chronic obstructive pulmonary disease (COPD), are emerging (7,8). In addition, the lack of effective drugs, shortages of well-trained medical care personnel, and unaffordable antifungal drugs result in severe outcomes. Therefore, an estimation of fungal disease burden is needed for China to increase public health awareness and facilitate effective interventions.