Publication: Clinicians’ challenges in managing patients with invasive fungal diseases in seven Asian countries: An Asia Fungal Working Group (AFWG) Survey
Issued Date
2020-01-01
Resource Type
ISSN
18783511
12019712
12019712
Other identifier(s)
2-s2.0-85081218232
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Mahidol University
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SCOPUS
Bibliographic Citation
International Journal of Infectious Diseases. (2020)
Suggested Citation
Ban Hock Tan, Arunaloke Chakrabarti, Atul Patel, Mitzi Marie M. Chua, Pei Lun Sun, Zhengyin Liu, Porpon Rotjanapan, Ruoyu Li, Retno Wahyuningsih, Methee Chayakulkeeree, Yee Chun Chen Clinicians’ challenges in managing patients with invasive fungal diseases in seven Asian countries: An Asia Fungal Working Group (AFWG) Survey. International Journal of Infectious Diseases. (2020). doi:10.1016/j.ijid.2020.01.007 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/53881
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Title
Clinicians’ challenges in managing patients with invasive fungal diseases in seven Asian countries: An Asia Fungal Working Group (AFWG) Survey
Other Contributor(s)
Peking University First Hospital
Universitas Kristen Indonesia
National Taiwan University Hospital
Chang Gung University
Singapore General Hospital
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Faculty of Medicine, Siriraj Hospital, Mahidol University
National Health Research Institutes Taiwan
Peking Union Medical College Hospital
Postgraduate Institute of Medical Education & Research, Chandigarh
Vedanta Institute of Medical Sciences
Cebu Institute of Medicine
Universitas Kristen Indonesia
National Taiwan University Hospital
Chang Gung University
Singapore General Hospital
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Faculty of Medicine, Siriraj Hospital, Mahidol University
National Health Research Institutes Taiwan
Peking Union Medical College Hospital
Postgraduate Institute of Medical Education & Research, Chandigarh
Vedanta Institute of Medical Sciences
Cebu Institute of Medicine
Abstract
© 2020 The Authors Background: Invasive fungal diseases (IFD) are a serious threat, but physicians in Asia lack access to many advanced diagnostics in mycology. It is likely that they face other impediments in the management of IFD. A gap analysis was performed to understand the challenges Asian physicians faced in medical mycology. Methods: The Asia Fungal Working Group (AFWG) conducted a web-based survey on management practices for IFD among clinicians in China, India, Indonesia, Philippines, Singapore, Taiwan and Thailand. Findings: Among 292 respondents, 51.7% were infectious disease (ID) specialists. Only 37% of respondents had received formal training in medical mycology. They handled only around 2–4 proven cases of each fungal infection monthly, with invasive candidiasis the most common. For laboratory support, the majority had access to direct microscopy (96%) and histopathology (87%), but galactomannan and azole levels were available to 60% and 25% of respondents, respectively. The majority (84%) used clinical parameters for treatment response monitoring, and 77% followed the Infectious Diseases Society of America guidelines. The majority (84%) did not use the services of an ID physician. Where febrile neutropenia was concerned, 74% of respondents used the empirical approach. Only 30% had an antifungal stewardship program in their hospital. Eighty percent could not use preferred antifungals because of cost. Interpretation: The survey identified inadequacies in medical mycology training, non-culture diagnostics, access to antifungal drugs, and local guidelines as the major gaps in the management of IFDs in Asian countries. These gaps are targets for improvement.