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EPIDEMIOLOGICAL, CLINICAL, AND GENOMIC LANDSCAPE OF COCCIDIOIDOMYCOSIS IN NORTHEASTERN BRAZIL
Eulálio, Kelsen Dantas et al. | Date Issued: 2024
Author
Eulálio, Kelsen Dantas
Kollath, Daniel R.
Martins, Liline Maria Soares
Deus Filho, Antonio de
Cavalcanti, Maria do Amparo Salmito
Moreira, Lucas Machado
Tenório, Bernardo Guerra
Alves, Lucas Gomes de Brito
Yamauchi, Danielle
Barrozo, Ligia Vizeu
Iii, George R. Thompson
Nacher, Mathieu
Stajich, Jason E.
Benard, Gil
Bagagli, Eduardo
Felipe, Maria Sueli Soares
Barker, Bridget M.
Trilles, Luciana
Teixeira, Marcus de Melo
Affilliation
Universidade Federal do Piauí. Hospital de Doenças Infecto Contagiosas. Teresina, PI, Brasil.
Northern Arizona University. The Pathogen and Microbiome Institute. Flagstaff, AZ, USA.
Universidade Federal do Piauí. Hospital de Doenças Infecto Contagiosas. Teresina, PI, Brasil.
Universidade Federal do Piauí. Hospital de Doenças Infecto Contagiosas. Teresina, PI, Brasil.
Universidade Federal do Piauí. Hospital de Doenças Infecto Contagiosas. Teresina, PI, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
University of Brasília. Faculty of Medicine. Brasília, DF, Brazil.
University of Brasília. Faculty of Medicine. Brasília, DF, Brazil.
Universidade Estadual Paulista. Instituto de Biociências de Botucatu. Departamento de Microbiologia e Imunologia. Botucatu, SP, Brasil.
University of São Paulo. Faculty of Philosophy, Languages and Literature, and Human Sciences. Department of Geography. São Paulo, SP, Brazil.
Department of Internal Medicine. Division of Infectious Diseases and Department of Medical Microbiology and Immunology. UC-Davis, Sacramento, CA, USA.
Centre d'Investigations Cliniques. INSERM 1424. Centre hospitalier de Cayenne - French Guiana. Cayenne, French Guiana.
University of California-Riverside. Department of Microbiology and Plant Pathology. Riverside, CA, USA.
Universidade de São Paulo. Faculdade de Medicina. Instituto de Medicina Tropical. Departamento de Dermatologia. Laboratório de Micologia Médica. São Paulo, SP, Brasil.
Universidade Estadual Paulista. Instituto de Biociências de Botucatu. Departamento de Microbiologia e Imunologia. Botucatu, SP, Brasil.
Universidade Católica de Brasília. Brasília, DF, Brasil.
Northern Arizona University. The Pathogen and Microbiome Institute. Flagstaff, AZ, USA.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Micologia. Rio de Janeiro, RJ, Brasil.
Northern Arizona University. The Pathogen and Microbiome Institute. Flagstaff, AZ, USA / University of Brasília. Faculty of Medicine. Brasília, DF, Brazil.
Abstract
Coccidioidomycosis, listed as a priority mycosis by the WHO, is endemic in the United States but often overlooked in Central and South America. Employing a multi-institutional approach, we investigate how disease characteristics, pathogen genetic variation, and environmental factors impact coccidioidomycosis epidemiology and outcomes in South America. We identified 292 cases (1978-2021) and 42 outbreaks in Piauí and Maranhão states, Brazil, the largest series outside the US/Mexico epidemic zone. The male-to-female ratio was 57.4:1 and the most common activity was armadillo hunting (91.1%) 4 to 30 days before symptom onset. Most patients (92.8%) exhibited typical acute pulmonary disease, with cough (93%), fever (90%), and chest pain (77%) as predominant symptoms. The case fatality rate was 8%. Our negative binomial regression model indicates that reduced precipitation levels in the current (p = 0.015) and preceding year (p = 0.001) predict heightened incidence. Unlike other hotspots, acidic soil characterizes this region. Brazilian strains differ genomically from other C. posadasii lineages. Northeastern Brazil presents a distinctive coccidioidomycosis profile, with armadillo hunters facing elevated risks. Low annual rainfall emerges as a key factor in increasing cases. A unique C. posadasii lineage in Brazil suggests potential differences in environmental, virulence, and/or pathogenesis traits compared to other Coccidioides genotypes.
Keywords
Coccidioidomycosis
Organização Mundial de Saúde (OMS)
United States
Central and South America
 
Publisher
Nature
Citation
EULÁLIO, Kelsen Dantas et al. Epidemiological, clinical, and genomic landscape of coccidioidomycosis in northeastern Brazil. Nature Communications, v. 15, n. 1, p. 1-11, Apr. 2024.
DOI
10.1038/s41467-024-47388-0
ISSN
2041-1723