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

Summary

This study examined fungal infections detected in Uganda’s laboratories from 2020 to 2024, finding that common yeast infections called Candida were the most frequently identified. Most cases occurred in women aged 16-35 years, particularly in the cities of Kampala and Mbarara. The research reveals that Uganda’s laboratories can only identify two types of fungi and cannot test which medications work best against them, highlighting the need for better diagnostic tools and training.

Background

Pathogenic fungi cause approximately 13 million infections and 1.5 million deaths worldwide annually, with inadequate surveillance and diagnosis 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. Despite WHO initiatives, diagnostic capacity remains a critical barrier to effective disease management.

Objective

This study describes laboratory-confirmed pathogenic fungal isolates from clinical samples in Uganda from January 2020 to May 2024. The study aims to highlight gaps in diagnostic capacity and identify trends in fungal infection distribution across geographic areas, demographics, and sample types.

Results

Among 8,136 clinical samples tested, fungal pathogens were isolated from 744 (9%) samples, predominantly from females (92%) aged 16-35 years (68%). Candida albicans was the most common isolate (65.4%), followed by non-albicans Candida spp. (30.6%) and C. neoformans (3.9%). Most isolates (93.7%) were from superficial samples, with high-vaginal swabs accounting for 71% of samples primarily from Kampala (32%) and Mbarara (26%) districts.

Conclusion

Candida spp. remain the most commonly isolated pathogenic fungi in Uganda, predominantly among females and individuals aged 16-35 years from Kampala and Mbarara districts. The study highlights significant gaps in fungal diagnostic capacity, with the national database limited to Candida and Cryptococcus genera, emphasizing the urgent need for improved diagnostic infrastructure, capacity-building, and surveillance systems.
  • Published in:PLoS One,
  • Study Type:Descriptive Analysis,
  • Source: PMID: 40674344
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