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Epidemiological, clinical, and genomic landscape of coccidioidomycosis in northeastern Brazil

Author

Listed:
  • Kelsen Dantas Eulálio

    (Federal University of Piauí-UFPI)

  • Daniel R. Kollath

    (Northern Arizona University)

  • Liline Maria Soares Martins

    (Federal University of Piauí-UFPI)

  • Antonio de Deus Filho

    (Federal University of Piauí-UFPI)

  • Maria do Amparo Salmito Cavalcanti

    (Federal University of Piauí-UFPI)

  • Lucas Machado Moreira

    (Fiocruz - RJ)

  • Bernardo Guerra Tenório

    (University of Brasília)

  • Lucas Gomes de Brito Alves

    (University of Brasília)

  • Danielle Yamauchi

    (Universidade Estadual Paulista/UNESP)

  • Ligia Vizeu Barrozo

    (University of São Paulo)

  • George R. Thompson III

    (Division of Infectious Diseases and Department of Medical Microbiology and Immunology, UC-Davis)

  • Mathieu Nacher

    (Centre hospitalier de Cayenne – French Guiana)

  • Jason E. Stajich

    (Department of Microbiology and Plant Pathology University of California-Riverside)

  • Gil Benard

    (University of São Paulo)

  • Eduardo Bagagli

    (Universidade Estadual Paulista/UNESP)

  • Maria Sueli Soares Felipe

    (Universidade Católica de Brasília)

  • Bridget M. Barker

    (Northern Arizona University)

  • Luciana Trilles

    (Fiocruz - RJ)

  • Marcus de Melo Teixeira

    (Northern Arizona University
    University of Brasília)

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.

Suggested Citation

  • Kelsen Dantas Eulálio & Daniel R. Kollath & Liline Maria Soares Martins & Antonio de Deus Filho & Maria do Amparo Salmito Cavalcanti & Lucas Machado Moreira & Bernardo Guerra Tenório & Lucas Gomes de , 2024. "Epidemiological, clinical, and genomic landscape of coccidioidomycosis in northeastern Brazil," Nature Communications, Nature, vol. 15(1), pages 1-11, December.
    • Handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-024-47388-0
    DOI: 10.1038/s41467-024-47388-0
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    References listed on IDEAS

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    1. Baddeley, Adrian & Turner, Rolf, 2005. "spatstat: An R Package for Analyzing Spatial Point Patterns," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 12(i06).
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