ArticleNature communications2024
Epidemiological, clinical, and genomic landscape of coccidioidomycosis in northeastern Brazil.
Article in Nature communications, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- Patient and caregiver experiences of barriers to longitudinal care in coccidioidal meningitis in California's central valley: a qualitative study.Lancet regional health. Americas · 2026Article
- Article
- Nursing-home residents' skin is a source of transmitted harmful and drug-resistant microbes.Nature · 2025Article
- Valley Fever: Fine Mineral Dust Modeling Points to High-Risk Regions and Seasons in California.Environmental health perspectives · 2025Article
- From soil to clinic: current advances in understandingMicrobiology and molecular biology reviews : MMBR · 2024Review
- Occurrence of coccidioidomycosis in a tertiary hospital in the Brazilian semi-arid region: diagnostic challenges.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2024Article
- Suspected Acute Pulmonary Coccidioidomycosis in Traveler Returning to Switzerland from Peru.Emerging infectious diseases · 2024Article
Corrections and comments
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Authors and funding
19 authors at 10 institutions in 3 countries.
Funding
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.
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Registered trials
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