Multicenter Case-Control Study of Behavioral, Environmental, and Geographic Risk Factors for Talaromycosis, Vietnam.

Talaromycosis is a life-threatening fungal disease that primarily affects immunocompromised persons in Southeast Asia. We conducted a multicenter, case-control study recruiting participants with advanced HIV disease in Vietnam; 205 case-patients with culture-confirmed talaromycosis were matched to 405 control-patients by age, sex, and CD4 count. Occupational exposure to tropical plants (odds ratio [OR] 1.73 [95% CI 1.10-2.73]; p = 0.017) and to farmed animals (OR 2.07 [95% CI 1.20-3.55]; p = 0.009) were independent risk factors for talaromycosis. Talaromycosis risk was higher in participants from highland regions than in persons from lowland regions (p<0.05). Participants from lowland regions who had lived or traveled to highland regions had a higher risk for talaromycosis (OR 3.15 [95% CI 1.49-6.64]; p = 0.003). This study confirms the epidemiologic correlation between talaromycosis and soil exposure and demonstrates an epidemiologic link between talaromycosis and residence in or travel to highland regions of Vietnam.

Duke Scholars

Author Thuy Le Medicine, Infectious Diseases