Fungal infections cause substantial morbidity and mortality. However, the burden of deep fungal infections is not well described in Uganda. We aimed to estimate the burden and etiology of histologically diagnosed deep fungal infections in Uganda. We retrospectively reviewed histology reports at the Pathology Reference Laboratory, Department of Pathology, Makerere University, Kampala, Uganda from January 1950 to September 2019 to identify any reports that had a fungal infection as the diagnosis. Over the study period, 697 cases of deep fungal infections were identified with an average incidence of 0.73/100,000 persons per decade. There was a general decline in the number of cases detected. Median age of the cases was 28 years (IQR: 11–40) and majority (59%) were male. The age group of 0–10 years were the most affected. The foot was the most affected part of the body (26%). Deep mycoses identified include eumycetoma (32%), subcutaneous phycomycosis (26%), histoplasmosis (9.2%), chromoblastomycosis (4.6%), aspergillosis (3.3%), cryptococcosis (3.3%), blastomycosis (1.6%), subcutaneous mycosis (1.4%), dermatomycosis (1.3%), coccidioidomycosis (0.6%), mucormycosis (0.6%), and sporotrichosis (0.1%). Histoplasma was the commonest causative agent (9.2%) followed by Aspergillus (3.4%) and Cryptococcus (3.3%), while 81% of the fungal pathogens were not identified to genus/species level. Only 31% of the cases were diagnosed clinically as deep fungal infections. There is a substantial burden of deep fungal infections caused by multiple fungal pathogens in Uganda. There is need to build local capacity for mycology so as to improve on the index of clinical suspicion and diagnostic capabilities.

中文翻译：

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通过组织学诊断的乌干达深部真菌感染：一项为期70年的回顾性研究

真菌感染会导致大量发病和死亡。但是，乌干达没有很好地描述深部真菌感染的负担。我们旨在评估在乌干达经组织学诊断的深部真菌感染的负担和病因。我们回顾了1950年1月至2019年9月在乌干达坎帕拉马凯雷雷大学病理学系病理学参考实验室的组织学报告，以鉴定出任何有真菌感染的报告作为诊断。在研究期间，确定了697例深部真菌感染病例，每十年平均发生0.73 / 100,000人。发现的病例数普遍下降。该病例的中位年龄为28岁（IQR：11-40），多数（59％）为男性。0-10岁年龄段受影响最大。脚是身体最受影响的部分（26％）。鉴定出的深部真菌病包括杜仲（32％），皮下真菌病（26％），胞浆菌病（9.2％），成色菌病（4.6％），曲霉菌病（3.3％），隐球菌病（3.3％），芽胞菌病（1.6％），皮下真菌病1.4％），皮癣菌病（1.3％），球虫菌病（0.6％），毛霉菌病（0.6％）和孢子体病（0.1％）。组织胞浆菌是最常见的病原体（9.2％），其次是曲霉菌（3.4％）和隐球菌（3.3％），而81％的真菌病原体未鉴定到属/种水平。临床上仅31％的病例被诊断为深部真菌感染。在乌干达，由多种真菌病原体引起的深部真菌感染负担很大。