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Invasive Candidiasis in Contexts of Armed Conflict, High Violence, and Forced Displacement in Latin America and the Caribbean (2005–2025)

Summary

Invasive candidiasis, a serious fungal blood infection caused by Candida species, is a major health crisis in Latin America and the Caribbean with death rates reaching 60% in vulnerable populations. The disease is worsening in areas affected by armed conflict, violence, and displacement where poor living conditions, overcrowding, malnutrition, and lack of healthcare create ideal conditions for the infection to develop and spread. Antifungal drugs are often unavailable or too expensive, and drug-resistant strains of Candida are becoming increasingly common, making treatment extremely challenging in these regions.

Background

Invasive candidiasis (IC), characterized primarily by candidemia, is a fungal infection with high mortality rates affecting global public health. In Latin America and the Caribbean, 50,000-60,000 IC-related hospitalizations occur annually with mortality rates reaching 60% in high-risk groups. Armed conflicts and structural violence in the region cause forced displacement, health system collapse, and conditions conducive to opportunistic infections like IC.

Objective

To review the epidemiology, burden, and clinical impact of invasive candidiasis in Latin America and the Caribbean, particularly in contexts of armed conflict, high violence, and forced displacement from 2005-2025. To identify risk factors, diagnostic challenges, antifungal resistance patterns, and mortality rates in vulnerable displaced and migrant populations.

Results

IC incidence in LA&C ranges from 0.74-6.0 cases per 1000 hospital admissions with 30-day mortality of 40.7-60%, higher than North America/Europe (30-40%). In displaced populations, candidemia incidence is 1-2 per 1000 admissions with mortality exceeding 65%. Non-albicans Candida species predominate (60-65%), with C. parapsilosis (25-30%), C. tropicalis (15-20%), and emerging C. auris showing high antifungal resistance rates.

Conclusion

IC represents a severe public health crisis in LA&C, particularly affecting displaced and migrant populations in conflict-affected areas. Urgent interventions are needed to strengthen mycological surveillance infrastructure, ensure access to echinocandins and lipid formulations of amphotericin B, improve diagnostic capacity, and establish early treatment protocols in vulnerable populations.
  • Published in:Journal of Fungi (Basel),
  • Study Type:Narrative Review,
  • Source: PMC12387756, PMID: 40863535
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