"The groundwork of all happiness is health." - Leigh Hunt

Fungal infections within the brain aren't just the stuff of flicks — Africa is affected by a deadly epidemic

American post-apocalyptic drama television series in 2023 The last of us, humans are headed for extinction as a lot of the species are damaged by a fungal infection of brain zombies. It could seem counterintuitive, but fungi can and do affect the human brain.

Fungi are in all places in the environment: within the air, within the soil, in decaying plant material, on our skin, and even in our gut as a part of our natural flora.

Microscopic, disease-causing fungi can invade different parts of the body, causing a spread of symptoms and health problems. In fact, contributing to fungal infections About 1.5 million deaths yearly.

I’m a neurobiologist who has been studying fungal infections of the brain for over 10 years. I used to be a part of this team recently. Posted a review Discuss the emergence, and re-emergence, of fungal infections in Africa, particularly sub-Saharan Africa. We conclude that Africa is affected by a silent, but costly, epidemic of fungal infections. We found that the emergence of fatal fungal infections within the region is principally attributable to the high burden of HIV infection, lack of access to quality health care, and unavailability of effective antifungal drugs.

What are fungal infections?

For the greater a part of human history, fungal infections were never a threat to human health. The major reason for that is that the majority fungi cannot survive in the new human body temperature of 37°C. However, climate change and other environmental pressures of leadership For the emergence of fungal species which are in a position to survive at human body temperature.

Nevertheless, our immune systems are quite able to fighting off fungal infections. For example, our bodies can locally create an acidic environment, limiting micronutrient availability and releasing antimicrobial agents.

However, when the immune system is weakened, fungi are in a position to evade the body's defenses and avoid detection. They can produce bioactive agents that help them avoid or adjust the host's immune response. Some are adapted to survive in hostile, low-nutrient and low-oxygen environments.

Immunocompromised individuals are liable to developing serious or life-threatening fungal infections. Accounts for Africa 67% The global burden of HIV, and opportunistic fungal infections are on the rise.

Some examples.

An example is opportunistic fungal diseases. cryptococcal meningitis, which emerged with the HIV epidemic within the late Eighties. Today, sub-Saharan Africa collaborates 73% All global cases and deaths resulting from the disease. Cryptococcal meningitis is attributable to a fungus, present in soil and bird droppings. Infection by fungi occurs when someone inhales fungal spores. This leads first to a lung infection and later to a fatal brain infection. Cryptococcal meningitis is the leading explanation for meningitis in adults in sub-Saharan Africa and is related to about 20% All AIDS deaths.

Effective treatment of cryptococcal meningitis is unaffordable and inaccessible to most infected individuals. Expenses The range between US$1,400 and US$2,500 per patient for a full two-week antifungal treatment course.

Development of cheaper drugs has been hampered by a limited understanding of how the fungus causes such severe brain damage.

Another example of an HIV-related opportunistic fungal infection is Pneumocystis jiroveci pneumonia. It is attributable to a ubiquitous, airborne fungus, which is transmitted from individual to individual. Pneumocystis rarely cause problems in individuals with healthy immune systems, but they act as reservoirs and transmit infections to individuals with weakened immune systems, which might cause serious symptoms including fever, dry cough, and difficulty respiration. May cause symptoms. Pneumocystis jirovecii causes pneumonia. 15%-20% HIV patients with respiratory problems.

Diagnosis of pneumocystis jiroveci pneumonia is pricey and requires a well-equipped laboratory. This might be a challenge in poor urban and rural health facilities in Africa. The fungus can also be extremely difficult to culture, which limits diagnosis and research.

Increasing load

In our review, He took a note Various aspects causing the emergence and re-emergence of fungal threats. These include climate change, the spread of immune diseases, medical advances resembling organ transplantation (the immune system is suppressed to attenuate immunity), using immunosuppressants to administer inflammatory diseases, and using antibiotics. Included.

Although these aspects will not be unique to Africa, the burden of fungal diseases and the number of individuals affected by them is high.

The COVID pandemic seems to have worsened the worldwide fungal burden. For example, A recent study Is Shown People who’ve been infected with COVID and have recovered are liable to infection with a fungus called mucormycosis, also referred to as black fungus. Lung damage attributable to COVID, high blood sugar, and steroids often used to treat it are predisposing aspects for black fungus infection. With a reduced ability to clear fungal spores and a reduced immune response, due to steroids, the fungus can enter and infect the sinuses and facial bones, eventually migrating to the brain.

But don't now we have antifungal drugs?

Most of the population affected by fungal infections live in rural or poor urban settlements.

With poorly funded and overburdened healthcare systems, many African countries are ill-prepared to take care of fungal infections. Additionally, a number of the antifungal drugs really helpful by the WHO – resembling flucytosine – are not available In most African countries. Sometimes ineffective and even toxic drugs are used as an alternative.

The emergence of drug-resistant fungal strains can also be a growing threat. Of greater concern is the rise in multidrug-resistant Candida species, azole-resistant Aspergillus species and clinically resistant Cryptococcus.

Management strategy

Fungal threats are putting pressure on overburdened health systems with a limited arsenal of treatment options.

Healthcare professionals, scientific researchers, policy makers and governments must address gaps within the diagnosis and management of fungal infections. This will help improve their coping skills.