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Publications

Journal Article Review Epublish 31 citations

PubMed: 36602962 DOI: 10.1371/journal.ppat.1011025

Race and ethnicity: Risk factors for fungal infections?

PLoS Pathog 19(1):e1011025

Authors: Jeffrey D Jenks, Chioma Inyang Aneke, Mohanad M Al-Obaidi, Matthias Egger, Lorena Garcia, Tommi Gaines, Martin Hoenigl, George R Thompson

Affiliations

  • Durham County Department of Public Health, Durham, North Carolina, United States of America.
  • Division of Infectious Diseases, Department of Medicine, Duke University, Durham, North Carolina, United States of America.
  • Department of Laboratory Medicine, National Institutes of Health, Bethesda, Maryland, United States of America.
  • Department of Veterinary Pathology and Microbiology, University of Nigeria, Nsukka, Nigeria.
  • Division of Infectious Diseases, Department of Medicine, University of Arizona, Tucson, Arizona, United States of America.
  • Division of Infectious Diseases, Medical University of Graz, Graz, Austria.
  • Department of Public Health Sciences, UC Davis School of Medicine, Davis, California, United States of America.
  • Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego, California, United States of America.
  • University of California Davis Center for Valley Fever, Sacramento, California, United States of America.
  • Department of Internal Medicine, Division of Infectious Diseases, University of California Davis Medical Center, Sacramento, California, United States of America.
  • Department of Medical Microbiology and Immunology, University of California Davis, Davis, California, United States of America.

Abstract

Racial and ethnic identities, largely understood as social rather than biologic constructs, may impact risk for acquiring infectious diseases, including fungal infections. Risk factors may include genetic and immunologic differences such as aberrations in host immune response, host polymorphisms, and epigenomic factors stemming from environmental exposures and underlying social determinants of health. In addition, certain racial and ethnic groups may be predisposed to diseases that increase risk for fungal infections, as well as disparities in healthcare access and health insurance. In this review, we analyzed racial and ethnic identities as risk factors for acquiring fungal infections, as well as race and ethnicity as they relate to risk for severe disease from fungal infections. Risk factors for invasive mold infections such as aspergillosis largely appear related to environmental differences and underlying social determinants of health, although immunologic aberrations and genetic polymorphisms may contribute in some circumstances. Although black and African American individuals appear to be at high risk for superficial and invasive Candida infections and cryptococcosis, the reasons for this are unclear and may be related to underling social determinants of health, disparities in access to healthcare, and other socioeconomic disparities. Risk factors for all the endemic fungi are likely largely related to underlying social determinants of health, socioeconomic, and health disparities, although immunologic mechanisms likely play a role as well, particularly in disseminated coccidioidomycosis.

MeSH

Mycoses, Risk Factors, Infections

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