Call for World Health Organization to classify Talaromycosis as a Neglected Tropical Disease

LIFE Worldwide’s David Denning has contributed to an international panel of experts calling for Talaormycosis to be classified as a Neglected Tropical Disease (NTD).

Talaromycosis is caused by the fungus Talaromyces marneffei and is endemic in the tropical and subtropical regions of Asia. Human infection is presumed to occur via inhalation of T. marneffei spores from the environment and predominantly occurs in immunocompromised hosts. The HIV pandemic has led to a rapid rise in global incidence, particularly in the hyperendemic areas of southeast Asia (Thailand, Vietnam, and Myanmar), east Asia (southern China, Hong Kong, Taiwan), and northeastern India. This infection has a high mortality rate (up to a third of cases). About 17,300 talaromycosis cases occur annually leading to 4,900 associated deaths.

Talaromycosis is characterised by disfiguring cutaneous lesions that predominate on the face and extremities. They are a feature of disseminated infection, which prompts hospital admission, and epitomise the visually stigmatising nature of the disease. Blood cultures are usually positive for the fungus.

The fact that this disease is predominantly confined to rural communities in low-income countries means that access to diagnosis and treatment is problematic, and by raising the profile of this condition the authors hope to encourage public health awareness and research funding.

A patient displaying extensive signs of Talaromycosis on feet and legs.

The author panel of this new paper is made up of physicians and scientists working in talaromycosis endemic areas, policy makers, and fungal experts that are working together to elevate the profile of this neglected mycosis and to petition the WHO to add to its NTD list. This study sets out the criteria for NTDs and demonstrated how this disease has similar characteristics to those already included on the WHO’s list. The criteria for inclusion are:

  • A disproportionate effect on populations living in poverty; and causing important morbidity and mortality – including stigma and discrimination – in such populations, justifying a global response
  • Primarily affecting populations living in tropical and sub-tropical areas
  • Immediately amenable to broad control, elimination or eradication by applying one or more of the five public health strategies adopted by the Department for Control of NTDs, and/or
  • Relatively neglected by research – i.e., resource allocation is not commensurate with the magnitude of the problem – when it comes to developing new diagnostics, medicines and other control tools.

To find out more about the global burden of this infection and how it can be curtailed, you can access the fulljournal article and its supplement in The Lancet:

Call for World Health Organization to classify Talaromycosis as a Neglected Tropical Disease

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