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Fungal diseases **range from minor skin and mucous membrane infections to
life-threatening disseminated disease**, cost **more than $7.2 billion a year
in direct US healthcare**, and are likely widely underdiagnosed.
Underdiagnosis is partly a question of whether the patient thinks to mention
anything and whether the clinician thinks to look. So CDC asked a simple
question: "Have you ever heard of the following infections?"
The answers
| Disease | Ever heard of it |
|---|---|
| Candidiasis (Candida infection) | 24.6% |
| Cryptococcosis | 9.0% |
| Coccidioidomycosis ("Valley fever") | 7.6% |
| Histoplasmosis | 7.5% |
| Aspergillosis | 5.1% |
| Blastomycosis | 4.1% |
| None of these | 68.9% |
Fewer than one third (31.1%) had heard of any of them.
Candidiasis at 24.6% is the outlier, and probably for a reason that has
nothing to do with invasive disease: most people who have heard the word know
it as thrush, not as a bloodstream infection.
Valley fever at 7.6% is the one that should worry a clinician most. It is
endemic in the American south-west, it presents as pneumonia, and a patient
who has never heard of it will not mention the desert trip that explains their
cough.
The survey was a good one
Porter Novelli's Fall 2019 ConsumerStyles survey, sent to a nationally
representative sample of 4,677 adults from Ipsos' KnowledgePanel —
recruited by mail using address-based probability sampling, and **given a
laptop or tablet and internet access if they needed one**, which is how an
online panel avoids being a survey of people who already had broadband.
3,624 completed it — a 77.5% response rate. Data were weighted to Consumer
Population Survey benchmarks for sex, age, race and ethnicity, education,
census region, household income, home ownership, metropolitan status and
internet access.
Who had heard of them
Three things were associated with awareness: female sex, **higher
education**, and an increased number of prescription medications.
The third is the interesting one. More prescriptions means more contact with
the medical system, and more reason to have encountered the word — awareness
follows exposure to healthcare rather than the other way round, which is
exactly backwards from what an early-diagnosis campaign needs.
**These are the first estimates of nationwide public awareness of fungal
diseases**, and exist to be a baseline: something for a later survey to be
compared against, and a measure of how far education has to go.
Source: Centers for Disease Control and Prevention, MMWR.
Licenza: CC0 1.0 (pubblico dominio) · Tratto da www.cdc.gov
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