Histoplasmosis in Africa: An emerging or a neglected disease?

TitleHistoplasmosis in Africa: An emerging or a neglected disease?
Publication TypeJournal Article
Year of Publication2018
AuthorsOladele, RO, Ayanlowo, OO, Richardson, MD, Denning, DW
JournalPLoS Negl Trop Dis
Volume12
Issue1
Paginatione0006046
Date Published2018 Jan
ISSN1935-2735
Abstract

Histoplasmosis in Africa has markedly increased since the advent of the HIV/AIDS epidemic but is under-recognised. Pulmonary histoplasmosis may be misdiagnosed as tuberculosis (TB). In the last six decades (1952-2017), 470 cases of histoplasmosis have been reported. HIV-infected patients accounted for 38% (178) of the cases. West Africa had the highest number of recorded cases with 179; the majority (162 cases) were caused by Histoplasma capsulatum var. dubuosii (Hcd). From the Southern African region, 150 cases have been reported, and the majority (119) were caused by H. capsulatum var. capsulatum (Hcc). There have been 12 histoplasmin skin test surveys with rates of 0% to 35% positivity. Most cases of Hcd presented as localised lesions in immunocompetent persons; however, it was disseminated in AIDS patients. Rapid diagnosis of histoplasmosis in Africa is only currently possible using microscopy; antigen testing and PCR are not available in most of Africa. Treatment requires amphotericin B and itraconazole, both of which are not licensed or available in several parts of Africa.

DOI10.1371/journal.pntd.0006046
Alternate JournalPLoS Negl Trop Dis
PubMed ID29346384