Histoplasmosis in HIV-Infected Persons, Yaoundé, Cameroon

Mandengue, Christine; Ngandjio, Antoinette; Atangana, Paul Jean Adrien

doi:10.3201/eid2111.150278

Cited by 26 publications

(20 citation statements)

References 7 publications

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“…So, most diagnoses of Hcc histoplasmosis are made postmortem, as premortem confirmatory tests are unavailable in low‐income countries. The underdiagnosis of histoplasmosis has been stressed by colleagues from Cameroon, who showed that histoplasmosis is frequently ignored in HIV‐positive patients with pulmonary symptoms as they were considered as TB infected 69 …”

Section: Discussionmentioning

confidence: 99%

Current burden of serious fungal infections in Republic of Congo

Amona

Denning

Moukassa

et al. 2020

Mycoses

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Background The Republic of Congo (RoC) is characterised by a high prevalence of tuberculosis and HIV/AIDS, which largely drive the epidemiology of serious fungal infections. Objective We aimed to estimate the current burden of serious fungal infections in RoC. Material and Methods Using local, regional or global data and estimates of population and at‐risk population groups, deterministic modelling was employed to estimate national incidence or prevalence of the most serious fungal infections. Results Our study revealed that about 5.4% of the Congolese population (283 450) suffer from serious fungal infections yearly. The incidence of cryptococcal meningitis, Pneumocystis jirovecii pneumonia and disseminated histoplasmosis in AIDS patients was estimated at 560, 830 and 120 cases per year. Oral and oesophageal candidiasis collectively affects 12 320 HIV‐infected patients. Chronic pulmonary aspergillosis, 67% post‐tuberculosis, probably has a prevalence of 3420. Fungal asthma (allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitisation) probably has a prevalence of 3640 and 4800, although some overlap due to disease definition is likely. The estimated prevalence of recurrent vulvovaginal candidiasis and tinea capitis is 85 440 and 178 400 respectively. Mostly related to agricultural activity, fungal keratitis affects an estimated 700 Congolese yearly. Conclusion These data underline the urgent need for an intensified awareness towards Congolese physicians to fungal infections and for increased efforts to improve diagnosis and management of fungal infections in the RoC.

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Section: Discussionmentioning

confidence: 99%

Current burden of serious fungal infections in Republic of Congo

Amona

Denning

Moukassa

et al. 2020

Mycoses

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“…However, it is important to note that this infection has been reported in several of the surrounding countries [ 36 , 37 ] and probably exists in Burkina Faso. Recently, Mandengue et al suggested that it is likely that a number of cases remain undiagnosed because the clinical presentation may somewhat mimic TB [ 5 ]. It is also possible that some patients may die before the diagnosis of histoplasmosis has been mentioned.…”

Section: Discussionmentioning

confidence: 99%

“…It is also possible that some patients may die before the diagnosis of histoplasmosis has been mentioned. Indeed, in their study, these authors found evidence of histoplasmosis in 13% of HIV-positive patients with persistent fever and coughing associated with cutaneous lesions [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, as already demonstrated in neighbouring countries [ 4 ], the fungal burden of serious fungal infections may be largely underestimated. This is mainly due to the limited access to adequate and reliable diagnostic tests, but also to erroneous presumptive diagnoses in favor of other prevalent infections, as reported for histoplasmosis and tuberculosis in Cameroon [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Burden of Severe Fungal Infections in Burkina Faso

Bamba¹,

Zida

Sangaré³

et al. 2018

JoF

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Because of the limited access to more powerful diagnostic tools, there is a paucity of data regarding the burden of fungal infections in Burkina Faso. The aim of this study was to estimate the incidence and prevalence of serious fungal infections in this sub-Saharan country. We primarily used the national demographic data and performed a PubMed search to retrieve all published papers on fungal infections from Burkina Faso and its surrounding West African countries. Considering the prevalence of HIV infection (0.8% of the population) and a 3.4% incidence of cryptococcosis in hospitals, it is estimated that 459 patients per year develop cryptococcosis. For pneumocystosis, it is suggested that 1013 new cases occur every year. Taking into account the local TB frequency (population prevalence at 0.052%), we estimate the prevalence of chronic pulmonary aspergillosis at 1120 cases. Severe forms of asthma with fungal sensitization and allergic bronchopulmonary aspergillosis are estimated to affect 7429 and 5628 cases, respectively. Vulvovaginal candidiasis may affect 179,000 women, and almost 1,000,000 children may suffer from tinea capitis. Globally, we estimate that roughly 1.4 million people in Burkina Faso (7.51% of the population) suffer from a serious fungal infection. These data should be used to drive future epidemiological studies, diagnostic approaches, and therapeutic strategies.

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“…Cases have been reported in many parts of Africa. [ 17 ] In Cameroun a prospective study found that 13% had microscopically confirmed histoplasmosis[ 18 ], preliminary unpublished results in South Africa using antigen detection showed that 10–15% of hospitalized HIV-infected patients with a CD4 count <100 had positive antigenemia. In South Asia, South East Asia, China histoplasmosis has also been increasingly reported in HIV patients[ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Histoplasma capsulatum antigen detection tests as an essential diagnostic tool for patients with advanced HIV disease in low and middle income countries: A systematic review of diagnostic accuracy studies

Nacher

Blanchet

Bongomin³

et al. 2018

PLoS Negl Trop Dis

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IntroductionDisseminated histoplasmosis, a disease that often resembles and is mistaken for tuberculosis, is a major cause of death in patients with advanced HIV disease. Histoplasma antigen detection tests are an important addition to the diagnostic arsenal for patients with advanced HIV disease and should be considered for inclusion on the World Health Organization Essential Diagnostics List.ObjectiveOur objective was to systematically review the literature to evaluate the diagnostic accuracy of Histoplasma antigen tests in the context of advanced HIV disease, with a focus on low- and middle-income countries.MethodsA systematic review of the published literature extracted data on comparator groups, type of histoplasmosis, HIV status, performance results, patient numbers, whether patients were consecutively enrolled or if the study used biobank samples. PubMed, Scopus, Lilacs and Scielo databases were searched for published articles between 1981 and 2018. There was no language restriction.ResultsOf 1327 screened abstracts we included a total of 16 studies in humans for further analysis. Most studies included used a heterogeneousgroup of patients, often without HIV or mixing HIV and non HIV patients, with disseminated or non-disseminated forms of histoplasmosis. Six studies did not systematically use mycologically confirmed cases as a gold standard but compared antigen detection tests against another antigen detection test. Patient numbers were generally small (19–65) in individual studies and, in most (7/10), no confidence intervals were given. The post test probability of a positive or negative test were good suggesting that this non invasive diagnostic tool would be very useful for HIV care givers at the level of reference hospitals or hospitals with the infrastructure to perform ELISA tests. The first results evaluating point of care antigen detection tests using a lateral flow assay were promising with high sensitivity and specificity.ConclusionsAntigen detection tests are promising tools to improve detection of and ultimately reduce the burden of histoplasmosis mortality in patients with advanced HIV disease.

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Histoplasmosis in HIV-Infected Persons, Yaoundé, Cameroon

Cited by 26 publications

References 7 publications

Current burden of serious fungal infections in Republic of Congo

Current burden of serious fungal infections in Republic of Congo

Burden of Severe Fungal Infections in Burkina Faso

Histoplasma capsulatum antigen detection tests as an essential diagnostic tool for patients with advanced HIV disease in low and middle income countries: A systematic review of diagnostic accuracy studies

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