Hospital morbidity due to paracoccidioidomycosis in Brazil (1998-2006)

Ziadir Francisco Coutinho; Bodo Wanke; Claudia Travassos; Rosely Magalhães Oliveira; Diego Ricardo Xavier; Carlos E A Coimbra Jr

doi:10.1111/tmi.12472

Hospital morbidity due to paracoccidioidomycosis in Brazil (1998-2006)

Trop Med Int Health. 2015 May;20(5):673-680. doi: 10.1111/tmi.12472. Epub 2015 Feb 26.

Authors

Ziadir Francisco Coutinho¹, Bodo Wanke¹, Claudia Travassos¹, Rosely Magalhães Oliveira¹, Diego Ricardo Xavier¹, Carlos E A Coimbra Jr¹

Affiliation

¹ Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.

PMID: 25645820
DOI: 10.1111/tmi.12472

Abstract

Objective: To analyse hospital morbidity records due to paracoccidioidomycosis in Brazil, including its nationwide distribution in time and space, as well as key epidemiological and sociodemographic characteristics.

Methods: Descriptive analysis of hospital morbidity records due to paracoccidioidomycosis covering the period January 1998 to December 2006. Hospital records were obtained from the Hospital Information System of the Brazilian Unified Health System (SIH/SUS).

Results: There were 6732 hospitalisations (82% male) due to paracoccidioidomycosis in the period, representing 4.3 per 1.0 million inhabitants. Admissions due to this mycosis were recorded in 27% of the 5560 Brazilian municipalities, covering 35% of the country. Ten municipalities concentrated 52% of all admissions. The temporal distribution of admissions for paracoccidioidomycosis showed a slight increase. The geographical analysis showed two distinct patterns of the disease: (i) traditional areas of southern and south-eastern regions, covering 60% of admissions, and (ii) a second pattern in northern Brazil revealed a transverse band of higher concentration with about 27% of admissions, particularly along the southern border of the Amazon region.

Conclusion: This first nationwide analysis of hospitalisation due to paracoccidioidomycosis in Brazil shows that it is the most prevalent systemic mycosis in Brazil. Despite its importance, there are major deficits in its proper registry, diagnostics and treatment. The particular epidemiological and medical challenges of paracoccidioidomycosis will not be met while the disease continues to be perceived as an isolated infectious entity restricted to a few faraway regions of the globe.

Keywords: enfermedades tropicales olvidadas; health services; hospitalisation; hospitalización; maladies tropicales négligées; micosis; morbidity; morbidité; morbilidad; mycoses; mycosis; paracoccidioidomicosis; paracoccidioidomycosis; paracoccidioïdomycose; services de santé; servicios sanitarios; tropical neglected diseases.