Fungal neuroinfections and fungaemia: unexpected increase of mortality from invasive fungal infections in 2005-2011 in comparison to 1989-1998: analysis of 210 cases.

OBJECTIVE: In this short communication we compared the data of fungaemia cases in Slovak hospitals from 1989-1998 published in 1999-2000 with data from 2005-2011. METHODS: Risk factors, etiology and outcome of fungaemia between two periods (1989-1998 vs. 2005-2011) were compared and risk factors for death assessed by univariate analysis (CDC 2006 Statistical Package). RESULTS: In comparison to 1989-1998 when only amphotericin B and fluconazole has been used (55%), in 2005-2011 only 35.2% patients received FLU, but 26.4% received voriconazole, 22% caspofungin and anidulafungin and about 6.6% lipid formulations of Amphotericin B. In etiology, while in 1989-1998 only 37.1% (115/310) represented non-albicans Candida (NAC) and non-Candida yeasts in 2005-2011 already reached 63.7%. The significant increase of breakthrough fungaemia may be a sign of inappropriate empiric therapy.

Malaria in hyperendemic region of Uganda has seasonal variations and is associated with low mortality.

OBJECTIVE: Majority of malaria cases in hyper-endemic areas have seasonal variations. The aim of this short research note is to refer and assess seasonal variability and mortality of malaria in Ngogwe in southeast Uganda in 2011/2012 season. METHODS: We analyzed clinical records of patients admitted to Buikwe-Ngogwe Hospital in the period from July 1, 2011 to August 25, 2012 to assess seasonality of malaria. RESULTS: Altogether, 23,675 patients were admitted to Buikwe-Ngogwe Hospital due to fever illness and 14,940 malaria-positive samples were obtained (63.1%) from these patients. We have observed significantly higher number of malaria cases in December compared to period of June - November (p<0.01). Mortality rate was only 0.48%. CONCLUSION: Interestingly, we have observed seasonal variability in malaria occurrence in Ngogwe, Southeast Uganda, which is, not correlating with rainy season but with movement of population to the areas closer to Lake Victoria. However, despite of high prevalence, mortality of this disease remained low. The reasons for low mortality are probably a good access to health care facility and adaptation of artemisinin-based combinational therapy for documented malaria.