Diagnostic capacity for cutaneous fungal diseases in the African continent.

Abstract

BACKGROUND:

Cutaneous fungal infections are very common, especially in poorer communities and with intercurrent HIV infection. Determining the fungal pathogen in skin-related fungal neglected tropical diseases (NTDs) determines optimal therapy. We undertook a country survey across many African countries to determine the diagnostic capacity for skin fungal diseases.

METHODS:

A detailed questionnaire was delivered to country contacts to collect data on availability, frequency, and location of testing for key diagnostic procedures and followed up with 2 rounds of validation by video call and by confirmation of individual country data confirmation by email.

RESULTS:

Of 47 countries with data, seven (15%) and 21 (45%) do not offer skin biopsy in the public or private sector, respectively, but 22 (46%) countries do it regularly, mostly in university hospitals. Direct microscopy is often performed in 20 of 48 (42%) countries in the public sector and not done in 10 (21%). Fungal cultures are often performed in 21 of 48 (44%) countries in the public sector but not done in nine (20%) or 21 (44%) in either public or private facilities. Histopathological examination of tissue is frequently used in 19 of 48 (40%) countries but not in nine (20%) countries in the public sector. The cost of diagnostics to patients was a major limiting factor in usage.

CONCLUSION:

Major improvements in the availability and use of diagnostic tests for skin, hair, and nail fungal disease are urgently needed across Africa.

• Authors: Aida S Badiane, Lala S Ramarozatovo, Safiatou N Doumbo, Ameyo M Dorkenoo, Christine Mandengue, Cara M Dunaisk, Mamadou Ball, Mariem K Dia, Gilles S L Ngaya, Hassane H Mahamat, Hortense Kalombo, Alasana Bah, Zimania Cá, Jose C Langa, Ayni M Mohamed, Margaret Mokomane, Sarah A Ahmed, Fahafahantsoa Rapalanoro Rabenja, Roderick J Hay, Richard O S Penney, Emma Orefuwa, David W Denning
• Journal: International journal of dermatology (Int J Dermatol) Vol. 62 Issue 9 Pg. 1131-1141 (Sep 2023) ISSN: 1365-4632 [Electronic] England
• PMID: 37340531 (Publication Type: Journal Article)
• Copyright: © 2023 The Authors. International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology.

Topics

• Humans
• Malaria
• HIV Infections
• Africa
• Dermatomycoses (diagnosis)
• Private Sector