Prevalence of Histoplasmosis among Persons with Advanced HIV Disease, Nigeria

Rita O Oladele; Iriagbonse I Osaigbovo; Alani S Akanmu; Olukemi A Adekanmbi; Bassey E Ekeng; Yahaya Mohammed; Mary A Alex-Wele; Mark O Okolo; Stephen T Ayanbeku; Uchechukwu S Unigwe; Iorhen E Akase; Alali Dan-Jumbo; Dennis Isralski; David W Denning; Alessandro C Pasqualotto; Tom Chiller

doi:10.3201/eid2811.220542

Prevalence of Histoplasmosis among Persons with Advanced HIV Disease, Nigeria

Rita O Oladele, Iriagbonse I Osaigbovo, Alani S Akanmu, Olukemi A Adekanmbi, Bassey E Ekeng, Yahaya Mohammed, Mary A Alex-Wele, Mark O Okolo, Stephen T Ayanbeku, Uchechukwu S Unigwe, Iorhen E Akase, Alali Dan-Jumbo, Dennis Isralski, David W Denning, Alessandro C Pasqualotto, Tom Chiller

Research output: Contribution to journal › Article › peer-review

Abstract

We sought to determine the prevalence of probable disseminated histoplasmosis among advanced HIV disease (AHD) patients in Nigeria. We conducted a cross-sectional study in 10 sites across 5 of 6 geopolitical zones in Nigeria. We identified patients with urinary samples containing CD4 cell counts <200 cells/mm3 or World Health Organization stage 3 or 4 disease who also had >2 clinical features of disseminated histoplasmosis, and we tested them for Histoplasma antigen using a Histoplasma enzyme immune assay. Of 988 participants we recruited, 76 (7.7%) were antigen-positive. The 76 Histoplasma antigen-positive participants had significantly lower (p = 0.03) CD4 counts; 9 (11.8%) were also co-infected with tuberculosis. Most antigen-positive participants (50/76; 65.8%; p = 0.015) had previously received antiretroviral treatment; 26/76 (34.2%) had not. Because histoplasmosis is often a hidden disease among AHD patients in Nigeria, Histoplasma antigen testing should be required in the AHD package of care.

Original language	English
Pages (from-to)	2261-2269
Number of pages	9
Journal	Emerging infectious diseases
Volume	28
Issue number	11
DOIs	https://doi.org/10.3201/eid2811.220542
Publication status	Published - Nov 2022

Keywords

Humans
Histoplasmosis/diagnosis
Prevalence
Cross-Sectional Studies
Nigeria/epidemiology
Histoplasma
HIV Infections/complications

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3201/eid2811.220542

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Oladele, R. O., Osaigbovo, I. I., Akanmu, A. S., Adekanmbi, O. A., Ekeng, B. E., Mohammed, Y., Alex-Wele, M. A., Okolo, M. O., Ayanbeku, S. T., Unigwe, U. S., Akase, I. E., Dan-Jumbo, A., Isralski, D., Denning, D. W., Pasqualotto, A. C., & Chiller, T. (2022). Prevalence of Histoplasmosis among Persons with Advanced HIV Disease, Nigeria. Emerging infectious diseases, 28(11), 2261-2269. https://doi.org/10.3201/eid2811.220542

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title = "Prevalence of Histoplasmosis among Persons with Advanced HIV Disease, Nigeria",

abstract = "We sought to determine the prevalence of probable disseminated histoplasmosis among advanced HIV disease (AHD) patients in Nigeria. We conducted a cross-sectional study in 10 sites across 5 of 6 geopolitical zones in Nigeria. We identified patients with urinary samples containing CD4 cell counts <200 cells/mm3 or World Health Organization stage 3 or 4 disease who also had >2 clinical features of disseminated histoplasmosis, and we tested them for Histoplasma antigen using a Histoplasma enzyme immune assay. Of 988 participants we recruited, 76 (7.7%) were antigen-positive. The 76 Histoplasma antigen-positive participants had significantly lower (p = 0.03) CD4 counts; 9 (11.8%) were also co-infected with tuberculosis. Most antigen-positive participants (50/76; 65.8%; p = 0.015) had previously received antiretroviral treatment; 26/76 (34.2%) had not. Because histoplasmosis is often a hidden disease among AHD patients in Nigeria, Histoplasma antigen testing should be required in the AHD package of care.",

keywords = "Humans, Histoplasmosis/diagnosis, Prevalence, Cross-Sectional Studies, Nigeria/epidemiology, Histoplasma, HIV Infections/complications",

author = "Oladele, {Rita O} and Osaigbovo, {Iriagbonse I} and Akanmu, {Alani S} and Adekanmbi, {Olukemi A} and Ekeng, {Bassey E} and Yahaya Mohammed and Alex-Wele, {Mary A} and Okolo, {Mark O} and Ayanbeku, {Stephen T} and Unigwe, {Uchechukwu S} and Akase, {Iorhen E} and Alali Dan-Jumbo and Dennis Isralski and Denning, {David W} and Pasqualotto, {Alessandro C} and Tom Chiller",

year = "2022",

month = nov,

doi = "10.3201/eid2811.220542",

language = "English",

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Oladele, RO, Osaigbovo, II, Akanmu, AS, Adekanmbi, OA, Ekeng, BE, Mohammed, Y, Alex-Wele, MA, Okolo, MO, Ayanbeku, ST, Unigwe, US, Akase, IE, Dan-Jumbo, A, Isralski, D, Denning, DW, Pasqualotto, AC & Chiller, T 2022, 'Prevalence of Histoplasmosis among Persons with Advanced HIV Disease, Nigeria', Emerging infectious diseases, vol. 28, no. 11, pp. 2261-2269. https://doi.org/10.3201/eid2811.220542

TY - JOUR

T1 - Prevalence of Histoplasmosis among Persons with Advanced HIV Disease, Nigeria

AU - Oladele, Rita O

AU - Osaigbovo, Iriagbonse I

AU - Akanmu, Alani S

AU - Adekanmbi, Olukemi A

AU - Ekeng, Bassey E

AU - Mohammed, Yahaya

AU - Alex-Wele, Mary A

AU - Okolo, Mark O

AU - Ayanbeku, Stephen T

AU - Unigwe, Uchechukwu S

AU - Akase, Iorhen E

AU - Dan-Jumbo, Alali

AU - Isralski, Dennis

AU - Denning, David W

AU - Pasqualotto, Alessandro C

AU - Chiller, Tom

PY - 2022/11

Y1 - 2022/11

N2 - We sought to determine the prevalence of probable disseminated histoplasmosis among advanced HIV disease (AHD) patients in Nigeria. We conducted a cross-sectional study in 10 sites across 5 of 6 geopolitical zones in Nigeria. We identified patients with urinary samples containing CD4 cell counts <200 cells/mm3 or World Health Organization stage 3 or 4 disease who also had >2 clinical features of disseminated histoplasmosis, and we tested them for Histoplasma antigen using a Histoplasma enzyme immune assay. Of 988 participants we recruited, 76 (7.7%) were antigen-positive. The 76 Histoplasma antigen-positive participants had significantly lower (p = 0.03) CD4 counts; 9 (11.8%) were also co-infected with tuberculosis. Most antigen-positive participants (50/76; 65.8%; p = 0.015) had previously received antiretroviral treatment; 26/76 (34.2%) had not. Because histoplasmosis is often a hidden disease among AHD patients in Nigeria, Histoplasma antigen testing should be required in the AHD package of care.

AB - We sought to determine the prevalence of probable disseminated histoplasmosis among advanced HIV disease (AHD) patients in Nigeria. We conducted a cross-sectional study in 10 sites across 5 of 6 geopolitical zones in Nigeria. We identified patients with urinary samples containing CD4 cell counts <200 cells/mm3 or World Health Organization stage 3 or 4 disease who also had >2 clinical features of disseminated histoplasmosis, and we tested them for Histoplasma antigen using a Histoplasma enzyme immune assay. Of 988 participants we recruited, 76 (7.7%) were antigen-positive. The 76 Histoplasma antigen-positive participants had significantly lower (p = 0.03) CD4 counts; 9 (11.8%) were also co-infected with tuberculosis. Most antigen-positive participants (50/76; 65.8%; p = 0.015) had previously received antiretroviral treatment; 26/76 (34.2%) had not. Because histoplasmosis is often a hidden disease among AHD patients in Nigeria, Histoplasma antigen testing should be required in the AHD package of care.

KW - Humans

KW - Histoplasmosis/diagnosis

KW - Prevalence

KW - Cross-Sectional Studies

KW - Nigeria/epidemiology

KW - Histoplasma

KW - HIV Infections/complications

U2 - 10.3201/eid2811.220542

DO - 10.3201/eid2811.220542

M3 - Article

C2 - 36286009

SN - 1080-6040

VL - 28

SP - 2261

EP - 2269

JO - Emerging infectious diseases

JF - Emerging infectious diseases

IS - 11

ER -

Prevalence of Histoplasmosis among Persons with Advanced HIV Disease, Nigeria

Abstract

Keywords

UN SDGs

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