Histoplasmosis Overlapping with HIV and Tuberculosis in Sub-Saharan Africa: Challenges and Research Priorities
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Date
2021
Authors
Kuate, Marius Paulin Ngouanom
Ekeng, Bassey Ewa
Kwizera, Richard
Mandengue, Christine
Bongomin, Felix
Journal Title
Journal ISSN
Volume Title
Publisher
Therapeutic Advances in Infectious Disease
Abstract
Histoplasmosis, tuberculosis and HIV are all highly prevalent in sub-Saharan Africa (SSA). Co-occurrence of two or more of these infections has been reported in several populations of patients, especially those with advanced HIV infection where these opportunistic infections contribute to a significant morbidity and mortality. With a high burden of pulmonary tuberculosis (PTB) secondary to HIV in SSA, histoplasmosis is commonly misdiagnosed as smear-negative PTB in HIV patients due to similar clinical and radiological presentations. This is also partly the result of the lack of trained clinical and laboratory personnel to make a definite diagnosis of histoplasmosis. There is a low index of clinical suspicion for histoplasmosis, and cases are mostly discovered accidently and documented through case reports and case series. Similarly, the high cost and lack of fungal diagnostics in most SSA countries makes it difficult to make a diagnosis. There is a need to build local capacity for mycology so that patients are managed to improve on the index of clinical suspicion and diagnostic capabilities. Moreover, simple accurate point-of-care diagnostic tests and first-line antifungal treatment for histoplasmosis are not available in many SSA countries. This review describes the existence of co-infections of histoplasmosis, tuberculosis and HIV in SSA, highlighting the challenges and research priorities.
Description
Keywords
histoplasmosis, HIV, sub-Saharan Africa, tuberculosis
Citation
Kuate, M. P. N., Ekeng, B. E., Kwizera, R., Mandengue, C., & Bongomin, F. (2021). Histoplasmosis overlapping with HIV and tuberculosis in sub-Saharan Africa: challenges and research priorities. Therapeutic Advances in Infectious Disease, 8, 20499361211008675.https://doi.org/10.1177%2F20499361211008675