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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

This comprehensive review examines candida fungal infections in conflict-affected areas of Latin America and the Caribbean, where wars, violence, and displacement create dangerous conditions that make infections more likely and harder to treat. In these regions, mortality from candida bloodstream infections reaches 65% or higher among displaced populations, compared to about 45-60% in regular hospitals. The main problems are lack of proper diagnostic equipment, limited access to effective antifungal medications, malnutrition, overcrowding in shelters, and the emergence of drug-resistant fungal strains.

Background

Invasive candidiasis (IC), primarily presenting as candidemia, is a fungal infection with high mortality rates affecting global public health. In Latin America and the Caribbean, the absence of standardized surveillance systems has led to documented incidences ranging from 0.74 to 6.0 cases per 1000 hospital admissions, with mortality rates up to 60% in high-risk groups. Armed conflicts, structural violence, forced displacement, and collapsed health systems create conditions that increase vulnerability to opportunistic infections like IC.

Objective

To examine the epidemiology, burden, and clinical impact of invasive candidiasis in Latin America and the Caribbean within contexts of armed conflict, high violence, and forced displacement from 2005-2025. The study aims to document how structural violence, displacement, and healthcare system collapse contribute to increased IC incidence and mortality in vulnerable populations.

Results

IC incidence in LA&C ranges from 1.2-1.9 cases per 1000 admissions in general populations, with higher rates (1.5-2.2 per 1000) in displaced/migrant populations near conflict zones. Mortality reaches 45-60% in general hospitals and exceeds 65% in displaced populations, driven by delayed diagnosis, restricted access to echinocandins, and high comorbidity burden. C. albicans prevalence decreased to 35-40%, while C. parapsilosis (25-30%), C. tropicalis (15-20%), and C. auris emergence show increasing antifungal resistance.

Conclusion

Invasive candidiasis represents a critical public health emergency in conflict-affected regions of Latin America and the Caribbean, with displaced and vulnerable populations experiencing disproportionately high mortality. Urgent interventions are needed including establishing mycological surveillance systems, ensuring continuous antifungal drug supply, strengthening diagnostic laboratory capacity, and integrating IC management into humanitarian health responses in violence-affected areas.
  • Published in:Journal of Fungi (Basel),
  • Study Type:Narrative Review,
  • Source: PMC12387756, PMID: 40863535
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