{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T21:25:41Z","timestamp":1768339541272,"version":"3.49.0"},"reference-count":32,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T00:00:00Z","timestamp":1670457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Global Action for Fungal Infections"},{"name":"JYLAG"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>The absence of awareness of fungal diseases as part of the differential diagnosis in at-risk populations has severe consequences. Here, we show how the active role of laboratories can improve patients\u2019 survival. Recently, major advances have been made in non-culture-based assays for fungal diseases, improving accuracy and turnaround time. Furthermore, with the introduction of proficiency control systems, laboratories are an easily monitored environment with good analytical accuracy. Diagnostic packages for opportunistic infections can overcome many deficiencies caused by the absence of awareness. In Guatemala, to make diagnosis accessible, we set up a diagnostic laboratory hub (DLH) providing screening for cryptococcosis, histoplasmosis and tuberculosis to a network of 13 healthcare facilities attending people living with HIV (PLWHIV). In two years, we screened 2127 newly HIV-diagnosed patients. The frequency of opportunistic infections was 21%, rising to 30.3% in patients with advanced HIV disease (&lt;200 CD4); 8.1% of these patients had more than one infection. With the implementation of this diagnostic package, mortality decreased by 7%, a key goal of many public health interventions. Screening for serious infection in high-risk populations can partially overcome training or experiential deficiencies among clinicians for life-threatening fungal diseases.<\/jats:p>","DOI":"10.3390\/jof8121285","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T01:51:26Z","timestamp":1670550686000},"page":"1285","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Diagnostic Mycology Laboratories Should Have a Central Role for the Management of Fungal Disease"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6176-0052","authenticated-orcid":false,"given":"Narda","family":"Medina","sequence":"first","affiliation":[{"name":"Asociaci\u00f3n de Salud Integral, Guatemala 01001, Guatemala"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8651-4405","authenticated-orcid":false,"given":"Ana","family":"Alastruey-Izquierdo","sequence":"additional","affiliation":[{"name":"Global Action for Fungal Infections, 1208 Geneva, Switzerland"},{"name":"Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, 28222 Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28222 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danicela","family":"Mercado","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Familiar \u201cLuis \u00c1ngel Garc\u00eda\u201d\/Hospital General San Juan de Dios, Guatemala 01001, Guatemala"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5626-2251","authenticated-orcid":false,"given":"David W.","family":"Denning","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n de Salud Integral, Guatemala 01001, Guatemala"},{"name":"Manchester Fungal Infection Group, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6225-7413","authenticated-orcid":false,"given":"Eduardo","family":"Arathoon","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n de Salud Integral, Guatemala 01001, Guatemala"},{"name":"Cl\u00ednica Familiar \u201cLuis \u00c1ngel Garc\u00eda\u201d\/Hospital General San Juan de Dios, Guatemala 01001, Guatemala"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Luis","family":"Rodriguez-Tudela","sequence":"additional","affiliation":[{"name":"Global Action for Fungal Infections, 1208 Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Kahneman, D., Sibony, O., and Sunstein, C.R. 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