Table 2.

The burden of serious fungal infections in Sierra Leone.

Burden of fungal infection				No underlying disease	HIV/AIDS	Respiratory disease	Cancer + immunocompromised	Critical care + surgery	Assumptions	References
Serious fungal infection	Rate per 100,000	Total	B
Cryptococcal meningitis	3.95	302	I		302				Country dependent	Lakoh et al.13
Pneumocystis pneumonia	8.40	643	I		643
Invasive aspergillosis	6.25	478	I		104		40	334	Rate in non-AML same as in AML patients	Lortholary et al. 27 Perkhofer et al.28
Chronic pulmonary aspergillosis post TB	16.67	1,275	I			1275			From Denning et al, Bull WHO 2011	Denning et al. 29
Chronic pulmonary aspergillosis post TB	52.53	4,018	P			4018			From Denning et al, Bull WHO 2011	Denning et al. 29
Chronic pulmonary aspergillosis - all	78.79	6,028	P			6,028			From Denning et al, Bull WHO 2011	Denning et al. 29
ABPA	65.41	5,004	P			5,004			From Denning et al, Med Mycol 2013	Denning et al. 30
SAFS	86.34	6,605	P			6,605
Candidemia	5.00	383	I				268	115	5/100,000 (mean of 2–11/100,000)	Arendrup et al. 31
Candida peritonitis	0.75	57	I					57		Montravers et al. 32
Oral candidiasis	75.63	5,786	I		5,786				90% of untreated HIV patients, with CD4 < 200	Matee et al. 33
Esophageal candidiasis	55.18	4,221	I		4,221				20% of patients not on ARVs and CD4 < 200, and 0.5% of those on ARVs	Smith et al. 31
Recurrent Candida vaginitis (⩾4×/year)	2,233.73	85,440		85,440					6% of adult female. Literature estimate is 5–8%	Foxman et al.33 Denning et al.34
Mucormycosis	0.20	15	I				15
Histoplasmosis	0.00	0	I
Fungal keratitis	13.30	1017	I	1017
Tinea capitis	3,483.00	266,450	P	266,450
Total serious fungal infections		376,643 4.92%		352,907	11,056	17,636	323

ABPA, allergic bronchopulmonary aspergillosis; AIDs, acquired immune deficiency syndrome; AML, acute myeloid leukemia; ARV, antiretrovirals; B, burden; HIV, human immunodeficiency virus; I, annual incidence; P, prevalence; SAFS, severe asthma with fungal sensitization; TB, tuberculosis.