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GAFFI meeting provides plan for integrating modern fungal diagnostic tools into routine care

September 09 2019

Culture and microscopy were traditionally the cornerstones of diagnosing fungal infections, but the past decade has seen an explosion of molecular and serological tests that can dramatically improve the speed and accuracy of diagnosis. However, access to these technologies is limited in some regions: only 9% of Latin American labs surveyed met the ECMM minimum standards of test provision (Falci and Pasqualotto, 2019).

A meeting in Lima (Peru) last week brought together >60 fungal experts from 24 countries across Latin America to formulate a plan for integrating new diagnostic tools into routine care. The meeting was organised by GAFFI in collaboration with the CDC and Pan-American Health Organization (PAHO) .

Dr Guillermo García-Effron presented a talk on the different options (and costs) for implementing modern diagnostics. PCR and MALDI-ToF are more complicated and expensive to set up, but lateral flow devices offer a cheaper and less technically demanding option (download the slide set).

Estimates of the burden of key fungal diseases in 18 Latin American countries were also presented (read the full document):

Disease

Incidence

Prevalence

Deaths

Cryptococcal meningitis

12,300

-

4,900

Pneumocystis pneumonia

66,100

-

27,800

Disseminated histoplasmosis

9,800

-

5,800

Invasive candidiasis

227,300

-

>100,000

Invasive aspergillosis

68,300

-

>30,000

Chronic pulmonary aspergillosis

-

33,600

>4,000

Fungal asthma

-

1,580,000

-

 

Key actions arising from the meetings include:

* Teleradiology is the digital sharing of encrypted X-ray/CT scan images with colleague at other sites, to obtain specialist expertise not available locally. Various companies and charitable organisations (e.g. via Téléradiologie Sans Frontières) recruit volunteer radiologists who are paired with radiologists in low-resource countries.