Histoplasmosis in Africa: An emerging or a neglected disease?

Rita Oladele, Olusola Ayanlowo, Malcolm Richardson, David Denning

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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. 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 179 cases; 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 Histoplasmosis capsulatum var. capsulatum (Hcc). There have been 12 histoplasmin skin test surveys with rates of 0-35% positivity. Most cases of Hcd presented as localized lesions in immunocompetent persons; however it was disseminated in AIDS patients. Rapid diagnosis of histoplasmosis in Africa is only possible currently using microscopy antigen testing and PCR for diagnosis are not available in most of Africa. Management is amphotericin B and itraconazole; both of which are not licensed or available in several parts of Africa.
Original languageEnglish
JournalPL o s Neglected Tropical Diseases
Early online date18 Jan 2018
Publication statusPublished - 18 Jan 2018


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