Fungal infections continue to impose a significant threat, globally 1–3 exacerbated by a plethora of challenges faced in the field of medical mycology (10). The present study to determine the popularity of medical mycology research topics among postgraduate microbiology trainees in one of Africa’s leading University in Uganda, showed that only 5 (3.3%) dissertations were written on fungal diseases. This means that medical mycology was the least researched dissertation topic at Makerere University.
One possible explanation to the limited research on fungal diseases among postgraduate trainees is the lack of formal training in medical mycology. I am the first and only formally trained mycologist at Makerere University. A result of the previous deficit is that the teaching of mycology is only a minor section; three credit units (maximum being five) in the training of postgraduate M. Med. students at Makerere University. Moreover, in the MICM program, medical mycology is not taught as a separate course unit but an integral component of fundamentals of microbiology course unit. With the limited mycology content in the medical microbiology postgraduate programs, perhaps, the student’s research dissertations were not guided by their interests but faculty research projects in which their studies were nested. This inference is supported by the fact that the most researched fungal diseases were cryptococcal meningitis (40 %, n = 2) which is the leading invasive fungal disease highlighted by HIV/AIDS in Uganda11.
Makerere University, College of Health Sciences through the Infectious Diseases Institute is an internationally recognised research hub for cryptococcal meningitis. However, as elsewhere in other resource limited countries, capacity for research in other fungal diseases is just improving in Uganda 10.
Additionally, we analysed the frequency of methods used for research in the theses (Fig. 3). Most methods that were used were molecular biology techniques. However, molecular techniques are not yet well developed for diagnosis of fungal diseases. Significantly, in low- and middle -income countries, like Uganda, where molecular tests are prohibitively costly, the predominant methods for diagnosis of fungal diseases are microscopy and culture based phenotypic techniques. In all the medical mycology theses, only phenotypic methods were used. Therefore, it is possible that the limited laboratory methods could have affected the choice of the students to conduct research in fungal diseases.
Another obvious and true possibility is that students lacked funding to explore their research interests in fungal diseases. Unlike other fields, dedicated funding for the training of students in medical mycology from major funding bodies is only emerging, where at present, the EU EDCTP is funding an early career fellowship at Makerere University.
Our findings are consistent with a report from a recent inaugural European Molecular Biology Organisation meeting on AIDS-related mycoses that listed training needs, requirements for laboratory testing methods and increased funding as priority areas for improved mycology research in low- and middle- income settings 10. A study from Gulu University in Uganda, also showed that using freely available online materials on medical mycology for teaching and learning can enhance capacity building in medical mycology 12. Therefore, there is need to establish a stand-alone formal medical mycology postgraduate programs in Uganda. Following, the Department of Medical Microbiology in collaboration with Manchester University, UK has developed a curriculum for MSc Medical Mycology to be hosted at Makerere University. It is expected that the program will lead to a steep rise in the number of medical mycologists in Uganda. The collaboration between Makerere University and Manchester University are also working to ensure that teaching materials can be made available online. The findings of our study are in agreement with the report by Brown et al 10 on improving mycology expertise in developing countries through training.