Epidemiology of Fungal Diseases and Infections

The epidemiology of fungal diseases encompasses a broad spectrum of infections ranging from superficial dermatophytoses to life-threatening systemic mycoses. These infections affect over a billion people worldwide each year and are driven by diverse factors including climate change, agricultural practices, urbanisation and the expanding population of immunocompromised individuals. The most common serious pathogens—Candida, Aspergillus, Cryptococcus and Pneumocystis species—cause invasive disease particularly in patients with cancer, transplants, HIV/AIDS or chronic lung disorders. Surveillance studies reveal regional variations in species distribution, incidence and antifungal susceptibility, with some areas reporting rising rates of multidrug resistance. Challenges in accurate burden estimation stem from limited diagnostic infrastructure, under-reporting and the absence of coordinated global surveillance networks. Nonetheless, modelling efforts and risk-based estimates have highlighted a substantial hidden burden of chronic pulmonary aspergillosis following tuberculosis, cryptococcal meningitis in HIV-infected populations and candidemia in intensive care settings. Improved access to rapid diagnostics, standardised reporting and antifungal stewardship are critical to inform empirical therapy and public health interventions. Understanding the drivers of emergence, host susceptibility and transmission dynamics is key to reducing morbidity and mortality from fungal infections on a global scale.

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Epidemiology of Fungal Diseases and Infections publication trend

The graph below shows the total number of articles in epidemiology of fungal diseases and infections across all publications each year (not limited to Nature Index journals).

Technical terms

Epidemiology: The study of the distribution, determinants and control of disease in populations.

Invasive aspergillosis: A severe infection in which Aspergillus species invade body tissues, commonly affecting the lungs of immunocompromised hosts.

Antifungal resistance: The reduced susceptibility of fungal pathogens to one or more antifungal agents, often due to genetic mutations.

Chronic pulmonary aspergillosis: A long-term lung disease caused by Aspergillus species, frequently developing after pulmonary tuberculosis or in patients with underlying lung pathology.

Opportunistic infection: An infection caused by pathogens that take advantage of weakened immune defences to establish disease.

References

1. Doubling of triazole resistance rates in invasive aspergillosis over a 10-year period, Belgium, 1 April 2022 to 31 March 2023. Eurosurveillance (2025).
2. Risk-Based Estimate of Human Fungal Disease Burden, China - Volume 26, Number 9—September 2020 - Emerging Infectious Diseases journal - CDC. Emerging Infectious Diseases (2020).
3. Diagnostic capacity for invasive fungal infections in advanced HIV disease in Africa: a continent-wide survey. The Lancet Infectious Diseases (2022).