{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T13:57:55Z","timestamp":1775570275068,"version":"3.50.1"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,10,3]],"date-time":"2019-10-03T00:00:00Z","timestamp":1570060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002850","name":"Fondo Nacional de Desarrollo Cient\u00edfico y Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["1180978"],"award-info":[{"award-number":["1180978"]}],"id":[{"id":"10.13039\/501100002850","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Risk Analysis"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Cryptococcus<\/jats:italic> is an important fungal pathogen worldwide, causing serious clinical manifestations that can affect immunocompetent patients and can be particularly severe for immunocompromised patients. The <jats:italic>Cryptococcus gattii s.s<\/jats:italic>. (AFLP4\/VGI), <jats:italic>Cryptococcus tetragattii<\/jats:italic> (AFLP\/VGIV), <jats:italic>Cryptococcus neoformans<\/jats:italic>, and <jats:italic>Cryptococcus deneoformans<\/jats:italic> have been isolated from both clinical and environmental sources in Europe. We aim to quantify the people in Europe and the entire Mediterranean area who are under risk associated with each of the three fungal pathogens in a spatially explicit way, generating a series of maps and population statistics per country. Niche modeling was applied to estimate the potential distribution of each fungal pathogen, then these models were overlapped with a map of population density to estimate risk levels. The potential number of people per risk level and per country was quantified using a map of population count per pixel. Prevalence of HIV per country was also included in the analysis to quantify the HIV\u2010infected population under potential risk. People under risk associated with exposure to <jats:italic>C. gattii<\/jats:italic> species (<jats:italic>C. gattii s.s<\/jats:italic>. and <jats:italic>C. tetragattii<\/jats:italic>) reached 137.65 million, whereas those exposed to <jats:italic>C. neoformans<\/jats:italic> and <jats:italic>C. deneoformans<\/jats:italic> were 268.58 and 360.78 million people, respectively. More than a half million HIV\u2010infected patients are exposed to each of the two species of the <jats:italic>C. neoformans<\/jats:italic> species complex, and more than 200,000 to the <jats:italic>C. gattii<\/jats:italic> species complex. The present results can be useful for public health planning by European governments, focusing on the provision of inputs for a \u201cscreen\u2010and\u2010treat\u201d approach, availability of medical resources, and continuous monitoring programs in risk zones.<\/jats:p>","DOI":"10.1111\/risa.13410","type":"journal-article","created":{"date-parts":[[2019,10,3]],"date-time":"2019-10-03T07:38:48Z","timestamp":1570088328000},"page":"524-533","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Spatial Quantification of the Population Exposed to <i>Cryptococcus neoformans<\/i> and <i>Cryptococcus gattii<\/i> Species Complexes in Europe: Estimating the Immunocompetent and HIV\/AIDS Patients Under Risk"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4878-8848","authenticated-orcid":false,"given":"Alberto J.","family":"Alaniz","sequence":"first","affiliation":[{"name":"Centro de Estudios en Ecolog\u00eda Espacial y Medio Ambiente Ecogeograf\u00eda  Santiago Chile"},{"name":"Departamento de Gesti\u00f3n Agraria, Facultad Tecnol\u00f3gica Universidad de Santiago de Chile  Santiago Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge G.","family":"Carvajal","sequence":"additional","affiliation":[{"name":"Centro de Estudios en Ecolog\u00eda Espacial y Medio Ambiente Ecogeograf\u00eda  Santiago Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario A.","family":"Carvajal","sequence":"additional","affiliation":[{"name":"Centro de Estudios en Ecolog\u00eda Espacial y Medio Ambiente Ecogeograf\u00eda  Santiago Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Cogliati","sequence":"additional","affiliation":[{"name":"Dipartimento Scienze Biomediche per la Salute Universit\u00e0 degli Studi di Milano  Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo M.","family":"Vergara","sequence":"additional","affiliation":[{"name":"Departamento de Gesti\u00f3n Agraria, Facultad Tecnol\u00f3gica Universidad de Santiago de Chile  Santiago Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,10,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyw366"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268818003102"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jen.12498"},{"issue":"1","key":"e_1_2_6_5_1","first-page":"1","article-title":"What makes Cryptococcus gattii a pathogen?","volume":"16","author":"Bielska E.","year":"2015","journal-title":"FEMS Yeast Research"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1801.111190"},{"key":"e_1_2_6_7_1","volume-title":"Gridded population of the world, version 4 (GPWv4): Population density, revision 10","author":"CIESIN and Columbia University","year":"2017"},{"key":"e_1_2_6_8_1","volume-title":"Gridded population of the world, version 4 (GPWv4): Population count, revision 10","author":"CIESIN and Columbia University","year":"2017"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/675213"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/femsyr\/fow045"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1462-2920.13915"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/13693786.2011.574239"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12866-014-0323-2"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ele.12410"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1472-4642.2010.00725.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/joc.5086"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep33828"},{"key":"e_1_2_6_18_1","unstructured":"GBIF. 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