‘There’s Not Enough Training & Expertise On Fungal Infection In India’

[Guest guest]

`There's Not Enough Training & Expertise On Fungal Infection In

India'

Mumbai,India

http://www.expresshealthcaremgmt.com/200603/infectioncontrol01.shtml

Prof W Denning is a leading physician at Manchester's

University Hospitals with expertise in fungal infections,

particularly aspergillosis, antifungal resistance and the treatment

of fungal infection. His clinical interests are in fungal diseases,

immunocompromised patients and complex hospital infection problems.

In his recent trip to India to interact with Indian doctors on

Aspergillus infections, Dr Denning spoke to Sapna Dogra.

What is the situation in India with regard to fungal infection and

treatment?

I was surprised to find that fungal infections are so common in

India. They appear to be complex than they are in Europe or North

America. For instance, after kidney transplantation, 10 per cent of

Indian patients get fungal infection whereas it is just 0.5 per cent

in North America and Europe; this gives some idea about the scale of

difference.

What could be the reasons for this high incidence?

Fungal infections are on the rise in India due to various reasons.

For instance, HIV/AIDS is one of the reasons for new cases.

Prolonged stay of patients like cancer patients in ICUs expose them

to fungal diseases. Around 20 per cent of blood culture are positive

for fungal infections in an Indian hospital, while in the US it is

nine per cent and in Britain it is 3.0 per cent.

What are the treatment options for Aspergillus infections?

Treatment options have improved recently with the introduction of

Caspofungin (Merck Sharpe & Dome) and Voriconazole (Pfizer).

However, these are expensive drugs and already there's so much load

on the healthcare system in India. The problems is compounded by the

fact that the diagnostic tools available are inadequate and symptoms

related to the disease are often subtle and therefore the diagnosis

is often missed, which is why doctors are unable to identify the

disease at early stages. There are also new diagnostics coming

through, but we are lagging behind in that which is why we still are

not able to make diagnosis fast and accurate enough in the area of

fungal diseases. So, there's need for better diagnostics. Also,

there are not enough people interested in the subject.

Does it mean it is a neglected area?

Well, there's not enough training and expertise in India. There are

only a very few experts to drive the field forward. It is a

neglected area particularly in diagnostics. However, clinically

doctors are competent and are doing good job, but lab support is

lacking. The awareness levels are very high here, but tests are

sophisticated and already the system is burdened with other

diseases. Mortality rates here are very high, for instance candida

in the blood causes 40 per cent mortality; Aspergillus in lungs

causes 50 per cent mortality. Hence there's need for more training,

better diagnostics, research to understand the problems and better

management and monitoring of fungal infections.

Tell us about your other activities.

I am interested in molecular diagnostics and I am trying to raise

venture capital to start a diagnostic company to do that.

sapnadogra@...