Spatial distribution of pathogenic fungal isolates from clinical samples in Uganda: Diagnostic gaps and trends, January 2020 - May 2024.

<h4>Background</h4>Pathogenic fungi cause approximately 13 million infections and 1.5 million deaths worldwide each year, yet surveillance and diagnosis remain inadequate in resource-limited settings. In Uganda, fungal infections affect approximately 4,099,357 per 45 million people annua...

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Main Authors: Priscilla Atim, Samuel Gidudu, Bernard Ssentalo Bagaya, Andrew Kambugu, Grace Najjuka, Atuhaire D Winfred, Benedict Kanamwanji, Esther Nabende, Adella Atukunda, Jonathan Kabazzi, Sylvia Joyoo, Hildah Tendo Nansikombi, Alex Riolexus Ario
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0327968
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author Priscilla Atim
Samuel Gidudu
Bernard Ssentalo Bagaya
Andrew Kambugu
Grace Najjuka
Atuhaire D Winfred
Benedict Kanamwanji
Esther Nabende
Adella Atukunda
Jonathan Kabazzi
Sylvia Joyoo
Hildah Tendo Nansikombi
Alex Riolexus Ario
author_facet Priscilla Atim
Samuel Gidudu
Bernard Ssentalo Bagaya
Andrew Kambugu
Grace Najjuka
Atuhaire D Winfred
Benedict Kanamwanji
Esther Nabende
Adella Atukunda
Jonathan Kabazzi
Sylvia Joyoo
Hildah Tendo Nansikombi
Alex Riolexus Ario
author_sort Priscilla Atim
collection DOAJ
description <h4>Background</h4>Pathogenic fungi cause approximately 13 million infections and 1.5 million deaths worldwide each year, yet surveillance and diagnosis remain inadequate in resource-limited settings. In Uganda, fungal infections affect approximately 4,099,357 per 45 million people annually, resulting in severe invasive diseases if untreated. This study describes laboratory-confirmed pathogenic fungal isolates from clinical samples in Uganda from January 2020 to May 2024, and highlights gaps in diagnostic capacity.<h4>Methods</h4>We abstracted data from the National Microbiology Reference Laboratory database, disaggregated pathogenic fungal isolates by the sex and age group of the patients, sample type, and isolated species, district, and year of isolation. Pathogenic fungal isolates were confirmed by culture and biochemical tests. Using Epi Info 7 software, we analyzed frequencies.<h4>Results</h4>Among 8,136 clinical samples tested, fungal pathogens were isolated from 744 (9%) samples. Of these, the majority were obtained from female (92%), persons aged 16-35 years (68%). Most fungal pathogens (93.7%) were isolated from superficial clinical samples, while 6.3% from deep samples. High-vaginal swabs accounted for 71% of the clinical samples, with most cases from Kampala (32%) and Mbarara (26%) districts. The pathogenic fungal species identified included C. albicans (65.4%), non-albicans Candida spp. (30.6%) and C. neoformans (3.9%). We observed a sharp decline of identified pathogenic fungi from 299 (40%) in 2020-39 (5%) in 2024, reflecting diagnostic disruptions during the COVID-19 pandemic.<h4>Conclusion</h4>Candida spp. were the most commonly isolated pathogenic fungi, mainly among females and individuals aged 16-35 years from Kampala and Mbarara districts. There is need for targeted interventions against candidiasis in these groups and locations. This study also highlights the gaps in fungal diagnostic capacity in Uganda, as the national database was limited to Candida and Cryptococcus, emphasizing the need for improved diagnostic infrastructure, capacity-building and surveillance to enhance detection of pathogenic fungi.
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spelling doaj-art-cf950a9a933443ecbf47aba52adace3b2025-08-20T02:41:13ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01207e032796810.1371/journal.pone.0327968Spatial distribution of pathogenic fungal isolates from clinical samples in Uganda: Diagnostic gaps and trends, January 2020 - May 2024.Priscilla AtimSamuel GiduduBernard Ssentalo BagayaAndrew KambuguGrace NajjukaAtuhaire D WinfredBenedict KanamwanjiEsther NabendeAdella AtukundaJonathan KabazziSylvia JoyooHildah Tendo NansikombiAlex Riolexus Ario<h4>Background</h4>Pathogenic fungi cause approximately 13 million infections and 1.5 million deaths worldwide each year, yet surveillance and diagnosis remain inadequate in resource-limited settings. In Uganda, fungal infections affect approximately 4,099,357 per 45 million people annually, resulting in severe invasive diseases if untreated. This study describes laboratory-confirmed pathogenic fungal isolates from clinical samples in Uganda from January 2020 to May 2024, and highlights gaps in diagnostic capacity.<h4>Methods</h4>We abstracted data from the National Microbiology Reference Laboratory database, disaggregated pathogenic fungal isolates by the sex and age group of the patients, sample type, and isolated species, district, and year of isolation. Pathogenic fungal isolates were confirmed by culture and biochemical tests. Using Epi Info 7 software, we analyzed frequencies.<h4>Results</h4>Among 8,136 clinical samples tested, fungal pathogens were isolated from 744 (9%) samples. Of these, the majority were obtained from female (92%), persons aged 16-35 years (68%). Most fungal pathogens (93.7%) were isolated from superficial clinical samples, while 6.3% from deep samples. High-vaginal swabs accounted for 71% of the clinical samples, with most cases from Kampala (32%) and Mbarara (26%) districts. The pathogenic fungal species identified included C. albicans (65.4%), non-albicans Candida spp. (30.6%) and C. neoformans (3.9%). We observed a sharp decline of identified pathogenic fungi from 299 (40%) in 2020-39 (5%) in 2024, reflecting diagnostic disruptions during the COVID-19 pandemic.<h4>Conclusion</h4>Candida spp. were the most commonly isolated pathogenic fungi, mainly among females and individuals aged 16-35 years from Kampala and Mbarara districts. There is need for targeted interventions against candidiasis in these groups and locations. This study also highlights the gaps in fungal diagnostic capacity in Uganda, as the national database was limited to Candida and Cryptococcus, emphasizing the need for improved diagnostic infrastructure, capacity-building and surveillance to enhance detection of pathogenic fungi.https://doi.org/10.1371/journal.pone.0327968
spellingShingle Priscilla Atim
Samuel Gidudu
Bernard Ssentalo Bagaya
Andrew Kambugu
Grace Najjuka
Atuhaire D Winfred
Benedict Kanamwanji
Esther Nabende
Adella Atukunda
Jonathan Kabazzi
Sylvia Joyoo
Hildah Tendo Nansikombi
Alex Riolexus Ario
Spatial distribution of pathogenic fungal isolates from clinical samples in Uganda: Diagnostic gaps and trends, January 2020 - May 2024.
PLoS ONE
title Spatial distribution of pathogenic fungal isolates from clinical samples in Uganda: Diagnostic gaps and trends, January 2020 - May 2024.
title_full Spatial distribution of pathogenic fungal isolates from clinical samples in Uganda: Diagnostic gaps and trends, January 2020 - May 2024.
title_fullStr Spatial distribution of pathogenic fungal isolates from clinical samples in Uganda: Diagnostic gaps and trends, January 2020 - May 2024.
title_full_unstemmed Spatial distribution of pathogenic fungal isolates from clinical samples in Uganda: Diagnostic gaps and trends, January 2020 - May 2024.
title_short Spatial distribution of pathogenic fungal isolates from clinical samples in Uganda: Diagnostic gaps and trends, January 2020 - May 2024.
title_sort spatial distribution of pathogenic fungal isolates from clinical samples in uganda diagnostic gaps and trends january 2020 may 2024
url https://doi.org/10.1371/journal.pone.0327968
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