At least 4.4 per cent of India’s population i.e. over 5.7 crore people, are affected by serious fungal diseases. And 10 per cent of them are from potentially deadly mold infections which have taken a deadly form in the last two Covid-pandemic years.
According to a review of over 400 research articles published in the journal Open Forum Infectious Diseases, the number may be on the higher side given that while fungal disease is frequent in India, its incidence and prevalence are unclear.
The review has come close on the heels of the World Health Organisation (WHO) list of fungal infections — "priority pathogens". The fungal priority pathogens list (FPPL) includes 19 fungi that represent the greatest threat to human health. The UN body has warned that some strains are increasingly drug-resistant and are growing at an alarming rate.
The review, conducted by researchers from the AIIMS, Delhi and AIIMS Kalyani in West Bengal besides PIGMER, Chandigarh and University of Manchester in the UK is the first to define the frequency or burden of various fungal infections in the country. The review is published in the journal Open Forum Infectious Diseases. The researchers estimate that 57,250,826 (over 5.7 crore)— or 4.4 per cent of India's population — are likely to be affected due to the fungal disease, much higher than the number of tuberculosis cases.
"While tuberculosis affects less than three million people in a year in India, the number of Indians affected by fungal disease is several times higher. No doubt, the total burden due to fungal diseases is huge but underappreciated," said Animesh Ray of AIIMS Delhi, the lead author of the article.
The review found that vaginal thrush —or yeast infection of vagina — affected around 2.4 crore women of reproductive age, with repeated attacks while 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, according to the study. The review shows that over 10 lakh people are thought to have potentially blinding fungal eye disease, and nearly two lakh had mucormycosis, so called "Black mold' which had erupted during the last two Covid pandemic years.
Deadly mold infections of lungs and sinuses affected over 250,000 (2.5 lakh) people, the researchers said. Similarly, another 1,738,400 (over 17 lakh) people had chronic aspergillosis — an infection of the respiratory system caused by a type of mold —and there were 35 lakh people with serious allergic lung mold disease, they said.
This total burden of serious fungal infections is over 10 times the annual incidence of tuberculosis in India, indicating an enormous population of patients affected by fungal diseases, the researchers said. Professor David Denning from The University of Manchester and Global Action For Fungal Disease noted that 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," Denning said adding that “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.”
As per the WHO, fungal infections are becoming increasingly resistant to treatment and can be dangerous to mankind due to a lack of focus, lack of surveillance, treatments and diagnostics.
"Emerging from the shadows of the bacterial antimicrobial resistance pandemic, fungal infections are growing, and are ever more resistant to treatments, becoming a public health concern worldwide," said Dr Hanan Balkhy, WHO Assistant Director-General, Antimicrobial Resistance (AMR) while Dr Haileyesus Getahun, WHO Director, AMR Global Coordination Department called for more data on the impact of fungal infections on health.