Year: 2025
Type: article
Abstract: their treatment especially in Africa.This study aims to review the distribution of emerging antifungal resistant pathogens in Africa.Methods: Key medical databases were searched followed by a narrative synthesis of relevant articles.Results: Candida auris, a multi drug-resistant fungus was retrospectively documented in a South African hospital in 2009 and is now endemic.It has also been isolated in Kenya, Nigeria, Egypt, Algeria and Sudan with anecdotal reports from Botswana.Triazole resistant Aspergillus fumigatus (TRAF) was first reported in Tanzania in 2014 and has now spread to Kenya, Cameroon, Nigeria and Burkina Faso.More than 40% of Candida parapsilosis isolates in South Africa demonstrate fluconazole resistance, the highest prevalence worldwide.Terbinafine-resistant Tricophyton mentagrophytes genotype VIII (Tricophyton indotiniae) was reported for the first time in Kwazulu-Natal province of South Africa in 2023.Discussion: The results probably represent a tip of the iceberg with these drug-resistant fungi being more widespread than documented in the scientific literature.The actual burden may be obscured by poor awareness about fungal diseases, limited diagnostic capacity, lack of surveillance for fungal diseases and low testing for antifungal resistance.Unsurprisingly, South Africa, with relatively more advanced diagnostic and surveillance capabilities has detected nearly all the target pathogens.Efforts at building capacity for clinical and environmental surveillance of fungi should, therefore, be intensified.Providing fungal diagnostics and mainstreaming antifungal susceptibility testing are imperative to achieving these goals.There needs to be better understanding of antifungal use patterns and improved access to antifungal medications in order to highlight antifungal stewardship targets and institute effective treatment guidelines.Ultimately, a one-health approach, paying attention to climate change and use of fungicides in agriculture should be adopted, as these have been shown to directly or indirectly induce drug resistance in fungi.In Nigeria, the agenda of amplifying fungi and fungal AMR is being championed by the Medical Mycology Society of Nigeria and Nigeria Fungal Disease Surveillance and Capacity Building and these can be replicated in more African states.Conclusion: All emerging drug resistant fungi have been detected in the African region.To curb the looming threat, fungi and antifungal resistance require amplification in the national action plans for AMR in all African countries and, indeed, globally.
Author: Mr Cedric Marsboom
Institutions: Université Libre de Bruxelles, Avia-GIS (Belgium)
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,900
OpenAlex ID: W4408046484