Alarming rise in fungal infection cases: PGIMER study

In spite of higher incidence of cases as compared to the West, India lacks infrastructure required for testing of fungal infections

By Jyotsna Singh
Published: Thursday 09 January 2014

Seven out of every 1,000 patients admitted in ICUs across India are affected with fungal infection, says a preliminary analysis of data collected by researchers in Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. The data was collected from 27 hospital ICUs across the country (11 government hospitals and 16 private hospitals).
At 39.55 per 1,000 patients, Global Hospitals of Hyderabad recorded the highest rate of infection. Delhi’s Safdarjung Hospital was second worst with 32.75 people per every 1,000 affected with fungal infection.

The infection can cause a variety of diseases, including blindness. Asthmatic and diabetic patients can face even worse affects of fungal infection.

“Nearly 10 per cent of farmers and agricultural workers going blind can be attributed to fungal infection. This is because while working in the field, tips of wood or straw enter their eyes and cause infection by touching the cornea,” said Arunaloke Chakrabarty, head of department of medical microbiology at PGIMER Chandigarh. The doctor who is also professor at WHO Collaborating Center for Reference & Research of Fungi of Medical Importance added that the damage in such cases cannot be reversed as people in rural India usually visit a health facility very late after the onset of disease.
Due to tropical climate, South Asia has a high incidence of fungal infections. For example, infection from yeast, which is a type of fungus, is found in 0.8 out of every 1,000 patients in the US; the incidence is 0.2 and 0.9 per 1,000 patients in Europe and Australia respectively. In India, 1-12 cases out of every 1,000 patients are found to be affected with this type of fungal infection.
“Apart from climate, there are other factors too. India has a large number of people from economically weaker sections and malnutrition makes children more vulnerable to the infections. Prevalence of quacks with little awareness of fungal infections is another cause for higher incidence of cases,” said Chakrabarty.

Detection of fungal infection is easy and inexpensive. But, this is possible only if there are enough laboratories with requisite facilities, which unfortunately are not found even in district centres across India. At present, only 71 laboratories are equipped to test such infections. “In a country like India we need at least 1,000 laboratories to test fungal infections,” said Chakrabarty.

Even though detection is cheap, effective treatment of the disease is costly. Drugs for the treatment can cost up to Rs 12,000 a day. There are cheaper drugs too, costing between Rs 300 and Rs 3,000. “A few medicines cost even about Rs 100. But they are very toxic and may lead to side effects and harm the kidneys,” said Chakrabarty.

According to sources, a high level meeting took place between the officials of the Union health ministry, the Indian Council of Medical Research and other stakeholders to discuss the issue. The officials have also hinted that the government is working on a proposal to spread awareness about the infections and its effects and keep a stock of anti-fungal drops at district health centres. All farmers with injury will be given the medicines to avoid the infection.

Fungal Infection Study Forum, a recently formed body of experts in the field, is drafting guidelines and protocols for timely detection and treatment of the diseases resulting from fungal infections.

The spectrum and aetiology of mycotic infections from a tertiary care hospital from western part of India

A study on superficial fungal infection from West Bengal: A brief report

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