A recent study, published in Nature, revealed significant gaps in patients' knowledge, attitudes, and practices (KAP) regarding superficial fungal infections, highlighting the urgent need for public health interventions and patient education. Conducted between October 2023 and March 2024, the cross-sectional study assessed 456 patients. Key findings showed that 32% of patients were uncertain about long-term treatment, 51% misunderstood the use of corticosteroids, and 69% believed they could stop medications once symptoms improved.1
Investigators pointed out, "The cascading effect observed in SEM suggests that improving health knowledge can lead to better practices indirectly by fostering positive attitudes,” emphasizing the importance of addressing both cognitive and attitudinal factors in designing effective interventions. “This underscores the importance of addressing both cognitive and attitudinal factors in designing interventions, as strengthening knowledge alone may not be sufficient without corresponding attitudinal changes," they said.1
The study also identified notable demographic disparities in KAP scores based on gender, age, education, and income. With average scores of 14.85 for knowledge, 27.01 for attitude, and 22.91 for practice, the research underscored the widespread misconceptions that contribute to inadequate patient understanding and negative attitudes. The authors called for targeted educational efforts to improve treatment adherence, correct misconceptions, and reduce antifungal resistance.1
Notably, lower-income individuals displayed surprisingly better knowledge and practices, underlining the importance of maintaining access to affordable healthcare and medications for these groups. "Given the influence of income on treatment practices, with lower-income individuals showing surprisingly better knowledge and practices, it is crucial to ensure that these groups continue to have access to affordable healthcare services and medications," investigators added.1
The study has limitations, including the self-reported KAP questionnaire could introduce response bias, and while it showed good internal consistency, it was not externally validated, limiting broader applicability. The sample was taken from a single hospital, which restricts the generalizability of the findings. Furthermore, the cross-sectional design prevents the establishment of causality, and the findings should be interpreted with caution as they cannot imply causal relationships.1
What You Need To Know
The study highlights significant patient misconceptions about the treatment of superficial fungal infections, underscoring the urgent need for enhanced education on long-term treatment and corticosteroid use.
Demographic disparities in patient knowledge and practices suggest that targeted educational efforts are crucial, with lower-income individuals showing unexpectedly better adherence to treatment.
Global initiatives, such as GAFFI's efforts, are focused on improving awareness and diagnostic capabilities in underserved regions, emphasizing the critical role of education in addressing the fungal infection burden.
Similar to the KAP study, a recent report by the WHO highlighted systemic challenges such as inadequate diagnostic tools and limited antifungal treatments, particularly in low- and middle-income countries. Both pieces emphasize the critical role of education, whether for patients or healthcare systems, in enhancing treatment practices and addressing the growing threat of resistance. These findings underline the importance of approaches that focus on improving patient understanding and healthcare infrastructure.
Additionally, earlier this year, we interviewed David W Denning, FRCP, FRCPath, FMedSci, about the GAFFI initiative, which seeks to address global fungal infection diagnostic and treatment gaps, particularly in underserved regions like Africa. GAFFI’s ambitious "95-95 by 2025" goal aims to diagnose and treat 95% of serious fungal infections globally by the end of 2025. A large aspect is raising awareness about fungal infections, which remain under-recognized and underfunded, especially in low-resource settings. GAFFI advocates for improved diagnostic infrastructure and the integration of education into healthcare systems to ensure better recognition and management of fungal diseases.3
GAFFI’s efforts to spread education include conducting surveys, publishing reports, hosting webinars, and partnering with institutions like the Africa CDC. By engaging medical schools and other stakeholders, GAFFI aims to educate healthcare workers on fungal infections and diagnostics, ultimately improving patient outcomes and fostering better healthcare practices in affected regions. Education is considered a tool in addressing diagnostic gaps and ensuring that healthcare providers are equipped to identify and treat fungal infections effectively.3
References
1. Ma, Y., Cen, W., Duan, M. et al. Patients knowledge attitudes and practices regarding superficial fungal infections suggest public health and patient education are warranted. Sci Rep 15, 15112 (2025). https://doi.org/10.1038/s41598-025-98919-8
3. Denning DW. The ambitious '95-95 by 2025' roadmap for the diagnosis and management of fungal diseases. Thorax. 2015;70(7):613-614. doi:10.1136/thoraxjnl-2015-207305
