Prior subclinical histoplasmosis revealed in Nigeria using histoplasmin skin testing.

Autor: Oladele RO; Department of Medical Microbiology & Parasitology, College of Medicine, University of Lagos, Lagos, Nigeria.; Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.; Global Action Fund for Fungal Infections, Geneva, Switzerland., Toriello C; Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico., Ogunsola FT; Department of Medical Microbiology & Parasitology, College of Medicine, University of Lagos, Lagos, Nigeria., Ayanlowo OO; Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria., Foden P; Medical Statistics Department, University Hospital of South Manchester, Manchester, United Kingdom., Fayemiwo AS; Department of Medical Microbiology & Parasitology, College of Medicine, University of Ibadan, Ibadan, Nigeria., Osaigbovo II; Department of Medical Microbiology, University of Benin Teaching Hospital, Benin City, Nigeria., Iwuafor AA; Department of Medical Microbiology & Parasitology, College of Medical sciences, University of Calabar, Calabar, Nigeria., Shettima S; Department of Medical Microbiology, Federal Medical Centre Yola, Yola, Nigeria., Ekundayo HA; Department of Medical Microbiology, General Hospital Ilorin, Ilorin, Nigeria., Richardson MD; Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.; Global Action Fund for Fungal Infections, Geneva, Switzerland.; Mycology Reference Centre Manchester, University Hospital of South Manchester, Manchester, United Kingdom., Denning DW; Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.; Global Action Fund for Fungal Infections, Geneva, Switzerland.; National Aspergillosis Centre, University Hospital of South Manchester, Manchester, United Kingdom.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2018 May 09; Vol. 13 (5), pp. e0196224. Date of Electronic Publication: 2018 May 09 (Print Publication: 2018).
DOI: 10.1371/journal.pone.0196224
Abstrakt: 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.
Databáze: MEDLINE
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