Abstract:

Previous studies have shown that geographic niche was a significant risk factor for developing T. marneffei (Tm) infection, and to date there are still lacking data of impact of economic status on the prevalence of Tm. Thus, we conducted this study, aiming to examine the correlation between prevalence of talaromycosis among HIV/AIDS-infected adult population and Asian country income, reported by World Bank data. A comprehensive medical literature review was performed to estimate the prevalence of T. marneffei infection among HIV/AIDS-infected adult population in Tm endemic and non-endemic countries and country income in Asia. Linear regression analyses were used to study the associations between Tm prevalence and Asian country income. Both unadjusted and adjusted models with Tm geographic distribution were analysed. A total of 48 Asian countries were included in the statistical analysis. Geographic distribution of talaromycosis was divided into three main regions: (i) Region 1: Regions of highest incidence of talaromycosis (>100 Tm cases reported in literature); (ii) Region 2: Endemic Tm countries and (iii) Region 3: Countries of imported or travel-associated Tm cases. Estimated Tm prevalence in the three regions were 3.9%, 2% and 0.02%, respectively. There was no statistical difference in GDP among three regions (P = 0.70). The linear regression analyses showed no associations between prevalence estimates of talaromycosis and Asian country income in both unadjusted and adjusted for geographic distribution of T. marneffei (P = 0.83). Most markedly, country geography is still a significant risk factor for T. marneffei infection (P < 0.001).

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