TY - JOUR
T1 - Prior subclinical histoplasmosis revealed in Nigeria using histoplasmin skin testing
AU - Oladele, Rita
AU - Ogunsola, Folasade T
AU - Toriello, Conchita
AU - Ayanlowo, Olusola
AU - Foden, Paul
AU - Fayemiwo, Adetona
AU - Osaigbovo, Iriagbonse
AU - Iwuafor, Anthony
AU - Shettima, Shuwaram
AU - Ekundayo, Halimat
AU - Richardson, Malcolm
AU - Denning, David
PY - 2018
Y1 - 2018
N2 - Objectives: Disseminated histoplasmosis is an AIDS-defining illness. Histoplasmosis is commonly misdiagnosed as tuberculosis. Nigeria has the second highest number of people living with HIV/AIDS in Africa. The present study was carried out to investigate the prevalence of skin sensitivity amongst Nigerians to histoplasmin.
Design: A cross-sectional study was conducted in six centres across five geopolitical zones of Nigeria.
Methods: We recruited both healthy non-HIV and HIV-positive adults with CD4 count ≥ 350 cells/mm3 regardless of their ART status from March to May 2017. Skin tests were performed intradermally; induration ≥5 mm were considered to be histoplasmin positive.
Results: 750 participants were recruited from Lagos (n=52), Yola (n=156), Ilorin (n=125), Calabar (n=120), Ibadan (n=202) and Benin (n=95). 467 (62.3%) were HIV negative, 247 (32.9%) were HIV positive and 36 (4.8%) did not know their HIV status. A total of 32/735 (4.4%) participants had a positive skin test. Study centre (p<0.001), education (p=0.002) and age (p=0.005) appeared to be significantly associated with positive skin reactivity at the 0.5% significance level, while sex (p=0.031) and occupation (p=0.031) would have been significant at the 5% significance level. Males had a higher rate of reactivity than females (p=0.031, 7% vs 3%). The highest positive rates were recorded from Benin City (13/86 (15%)) and Calabar (7/120 (6%)) and no positives were recorded in Lagos (p<0.001). HIV status was not statistically significant (p=0.70).
Conclusion: Histoplasmosis diagnostics should be included in the Nigerian HIV guidelines. Epidemiological vigilance of progressive disseminated histoplasmosis should be considered by local health authorities.
AB - Objectives: Disseminated histoplasmosis is an AIDS-defining illness. Histoplasmosis is commonly misdiagnosed as tuberculosis. Nigeria has the second highest number of people living with HIV/AIDS in Africa. The present study was carried out to investigate the prevalence of skin sensitivity amongst Nigerians to histoplasmin.
Design: A cross-sectional study was conducted in six centres across five geopolitical zones of Nigeria.
Methods: We recruited both healthy non-HIV and HIV-positive adults with CD4 count ≥ 350 cells/mm3 regardless of their ART status from March to May 2017. Skin tests were performed intradermally; induration ≥5 mm were considered to be histoplasmin positive.
Results: 750 participants were recruited from Lagos (n=52), Yola (n=156), Ilorin (n=125), Calabar (n=120), Ibadan (n=202) and Benin (n=95). 467 (62.3%) were HIV negative, 247 (32.9%) were HIV positive and 36 (4.8%) did not know their HIV status. A total of 32/735 (4.4%) participants had a positive skin test. Study centre (p<0.001), education (p=0.002) and age (p=0.005) appeared to be significantly associated with positive skin reactivity at the 0.5% significance level, while sex (p=0.031) and occupation (p=0.031) would have been significant at the 5% significance level. Males had a higher rate of reactivity than females (p=0.031, 7% vs 3%). The highest positive rates were recorded from Benin City (13/86 (15%)) and Calabar (7/120 (6%)) and no positives were recorded in Lagos (p<0.001). HIV status was not statistically significant (p=0.70).
Conclusion: Histoplasmosis diagnostics should be included in the Nigerian HIV guidelines. Epidemiological vigilance of progressive disseminated histoplasmosis should be considered by local health authorities.
KW - Histoplasmosis
KW - Nigeria
U2 - 10.1371/journal.pone.0196224
DO - 10.1371/journal.pone.0196224
M3 - Article
SN - 1932-6203
VL - 13
JO - PLoS ONE
JF - PLoS ONE
IS - 5
ER -
