Diagnostic Options for Pulmonary Fungal Diseases in Africa

Background Fungal lung diseases are global in distribution and require specific tests for diagnosis. We report a survey of diagnostic service provision in Africa.

Methods A written questionnaire was followed by a video conference call with each respondent(s) and external validation. To disseminate the questionnaire, a snowball sample was used.

Results Data were successfully collected from 50 of 51 African countries with populations >1 million. The questionnaire was completed by respondents affiliated to 72 health facilities, of whom 33 of 72 respondents (45.8%) reported data for the whole country while others reported data for a specific region/province. In the public sector, chest X-ray and CT scan are done often or occasionally in 49 (98%) and 37 (74%) countries, and less often in the private sector. Bronchoscopy and spirometry were often or occasionally done in 28 (56%) and 18 (36%) of countries in the tertiary health facilities of public sector. The most conducted laboratory diagnostic assay is fungal culture (often or occasionally) in 29 (58%) countries.

Conclusion This survey has found a huge disparity of diagnostic test capability across the African continent. Some good examples of good diagnostic provision and very high-quality care were seen, but this is unusual. The unavailability of essential testing such as spirometry was noted which has high impact in lung diseases diagnosis. It is important for countries to implement tests basing on the WHO Essential Diagnostic List.