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Diagnostic Capacity for Fungal Infections in Tertiary Hospitals in Nigeria and Ghana – An Onsite Baseline Audit of 9 Sites

Summary

Researchers audited fungal disease testing capabilities in major hospitals across Nigeria and Ghana. They found that most hospitals lack basic equipment, trained staff, and procedures needed to diagnose serious fungal infections like cryptococcal meningitis and invasive aspergillosis. The study highlights urgent needs for investment in laboratory infrastructure and personnel training to improve diagnosis of neglected fungal diseases in Africa.

Background

Over a billion people are estimated to have fungal infections globally, with 15-30% being serious. Fungal diseases have received little public health attention despite millions dying annually from conditions like cryptococcal meningitis, invasive candidiasis, and invasive aspergillosis. Many resource-limited countries struggle with weak laboratory systems lacking adequate infrastructure and human resources for fungal diagnostics.

Objective

To assess diagnostic mycology capacity and available fungal diagnostic services in microbiology laboratories of eight tertiary hospitals in Nigeria and one in Ghana. The audit aimed to provide a baseline for monitoring and evaluating capacity building efforts at selected sentinel sites for fungal disease surveillance programs.

Results

Only 33.3% of laboratories had dedicated mycology benches, and just 11.1% had trained mycology personnel. Less than half had functional biosafety cabinets (22.2%), standard operating procedures (11.1%), or mycology atlases (22.2%). Annual fungal samples ranged from 0-208 with 0-94 isolates identified. Only one laboratory potentially met minimum ECMM Blue status requirements.

Conclusion

The audit revealed critical deficits in basic infrastructure, material resources, dedicated human resources, and laboratory capacity to detect serious fungal infections in tertiary hospitals across Nigeria and Ghana. Sustained advocacy and investment in diagnostic mycology infrastructure and personnel training are essential to strengthen laboratory systems for fungal disease detection.
  • Published in:International Journal of Public Health,
  • Study Type:Laboratory Audit,
  • Source: PMID: 39611082
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