The current state of clinical mycology in Africa: a European Confederation of Medical Mycology and International Society for Human and Animal Mycology survey.

Africa, although not unique in this context, is a favourable environment for fungal infections, given the high burden of risk factors. An online survey was developed asking about laboratory infrastructure and antifungal drug availability. We received 40 responses (24·4% response rate) of 164 researchers contacted from 21 African countries. Only five institutions (12·5%) of 40 located in Cameroon, Kenya, Nigeria, Sudan, and Uganda potentially fulfilled the minimum laboratory requirements for European Confederation of Medical Mycology Excellence Centre blue status. Difficulties included low access to susceptibility testing for both yeasts and moulds (available in only 30% of institutions) and Aspergillus spp antigen detection (available in only 47·5% of institutions as an in-house or outsourced test), as well as access to mould-active antifungal drugs such as amphotericin B deoxycholate (available for 52·5% of institutions), itraconazole (52·5%), voriconazole (35·0%), and posaconazole (5·0%). United and targeted efforts are crucial to face the growing challenges in clinical mycology.

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Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

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Declaration of interests DRF received payments for educational material from Gilead Sciences; honoraria for lectures from Gilead Sciences, Merck Sharp & Dohme, Pfizer, and United Medical; support for attending meetings and travel from Merck, Sharp & Dohme, Gilead Sciences, Pfizer, and United Medical; and participated on an advisory board of Merck, Sharp & Dohme and GlaxoSmithKline, outside the submitted work. AA received honoraria from Gilead Sciences and Pfizer; and travel grants from Astellas, outside the submitted work. JS received research grants from the Ministry of Education and Research and Basilea Pharmaceuticals; and received travel grants from the German Society for Infectious Diseases and Meta-Alexander Foundation, outside the submitted work. JPG received funds for participating at educational activities organised on behalf of Astellas, Biotoscana, Gilead Sciences, Merck, Sharp & Dohme, and Scynexis; and received research funds from Cidara, Fabbrica Italiana Sintetici, Gilead Sciences, and Scynexis, outside the submitted work. OAC reports grants from Actelion, Amplyx, Astellas, Basilea, Cidara, Da Volterra, The Deutsche Forschungsgemeinschaft, F2G, German Federal Ministry of Research and Education, German Research Foundation, Gilead Sciences, Immunic, Janssen, Medicines Company, MedPace, Melinta Therapeutics, Merck, Sharpe & Dohme, Pfizer, and Scynexis; and personal fees from Actelion, Allecra Therapeutics, Al-Jazeera Pharmaceuticals, Amplyx, Astellas, Basilea, Biosys, Cidara, Da Volterra, Entasis, F2G, Gilead Sciences, Grupo Biotoscana, IQVIA, Matinas, MedPace, Menarini, Merck, Sharpe & Dohme, Mylan, Nabriva, Noxxon, Octapharma, Paratek, Pfizer, Pharmaceutical Solutions Industry, Roche Diagnostics, Scynexis, and Shionogi, outside the submitted work. JFM received grants from F2G and Pulmozyme; has been a consultant to Merck Sharpe & Dohme and Scynexis; and has received speaker's fees from Gilead, Teva Pharmaceutical Industries, and United Medical. NPG received research grants from the National Institutes of Health, Centers for Disease Control and Prevention, Bill & Melinda Gates Foundation, and the UK Medical Research Council, outside the submitted work. ROO has received grants from Gilead Sciences and Pfizer; payment for lectures from Pfizer; and participated on an advisory board for Pfizer, outside the submitted work. BKO received research funds from The Foundation for Technological Innovation, outside the submitted work; and the funds to organise a symposium from Immuno-Mycologics. COM has received grants from Gilead Sciences and Merck Sharp & Dohme Australia; received payment for lectures from Gilead Sciences, Merck Sharp & Dohme, and Pfizer; and participated in a data safety monitoring board for Gilead Sciences and Merck Sharp & Dohme, outside the submitted work. ACP received research grants support from Gilead Sciences, Immuno-Mycologics, Merck, Sharp & Dohme, and Pfizer; and has given paid talks and consulted for Gilead Sciences, Immuno-Mycologics, Merck, Sharp & Dohme, Pfizer, Teva, and United Medical, outside the submitted work. MH received research funding from Astellas, Euroimmun, the National Institutes of Health US, Gilead, Pfizer, and Scynexis, outside the submitted work. All other authors declare no competing interests.