Clinical and Eco-Epidemiological Aspects of a Novel Hyperendemic Area of Paracoccidioidomycosis in the Tocantins-Araguaia Basin (Northern Brazil), Caused by Paracoccidioides sp

Alessandra G Krakhecke-Teixeira; Danielle H Yamauchi; Alexsandra Rossi; Herdson R de Sousa; Hans G Garces; Joaquim L Júnior; Antônio O S Júnior; Maria Sueli S Felipe; Eduardo Bagagli; Heitor F de Andrade Jr; Marcus de M Teixeira

doi:10.3390/jof8050502

Clinical and Eco-Epidemiological Aspects of a Novel Hyperendemic Area of Paracoccidioidomycosis in the Tocantins-Araguaia Basin (Northern Brazil), Caused by Paracoccidioides sp

J Fungi (Basel). 2022 May 12;8(5):502. doi: 10.3390/jof8050502.

Affiliations

¹ Tocantins Department of Public Health, Palmas 77015-007, TO, Brazil.
² Institute of Tropical Medicine, University of São Paulo, São Paulo 05403-000, SP, Brazil.
³ Department of Chemical and Biological Sciences, São Paulo State University "Júlio de Mesquita Filho", Botucatu 18618-687, SP, Brazil.
⁴ Núcleo de Medicina Tropical, Faculty of Medicine, University of Brasília, Campus Universitário Darcy Ribeiro, Brasília 70910-900, DF, Brazil.
⁵ Oswaldo Cruz Foundation (Fiocruz), Brasília 70904-130, DF, Brazil.
⁶ Medical School, Federal University of Tocantins, Araguaína 77402-970, TO, Brazil.
⁷ Graduate Program in Genomic Sciences and Biotechnology, Catholic University of Brasília, Brasília 70790-160, DF, Brazil.

Abstract

Paracoccidioidomycosis (PCM) is the most prevalent systemic mycosis in Brazil. The disease is caused by dimorphic fungi nested within the Paracoccidioides genus. We described 106 PCM cases (47.1 cases/year) at the Tropical Diseases Public Hospital of Tocantins State. PCM was prevalent in males and rural workers over 50 years; the chronic pulmonary form predominated in 67% of cases. The male-to-female ratio was 2.65:1, with more women affected than other endemic regions of Brazil. Urban or indoor activities were reported in women and are ascribed to disease urbanization. qPCR-based assays confirmed the identification of Paracoccidioides DNA in 37 biological specimens. Paracoccidioides sp. DNA was found in 53% of the environmental samples, suggesting autochthonous infections. Therefore, the Tocantins-Araguaia basin must be considered a novel hyperendemic area of PCM in Brazil, reinforcing the importance of including PCM as a notifiable disease, requiring specific diagnosis and health measures.

Keywords: Northern Brazil; Paracoccidioides brasiliensis; Paracoccidioides lutzii; Tocantins-Araguaia basin; paracoccidioidomycosis.

Grants and funding

This study was supported by the Tocantins State Department of Science and Technology (SECT) and the Tocantins State Council for Science and Technology (CEPT) for fellowships and support of AGK in its doctoral work. The research was on the scientific collaboration agreement between FMT and IMTSP/USP and was partially supported by LIMHC/FMUSP.