Mapping histoplasmosis in South East Asia - implications for diagnosis in AIDS.

Abstract:

:Histoplasmosis caused by the fungus Histoplasma capsulatum is often lethal in patients with AIDS. Urine antigen testing is highly sensitive and much quicker for diagnosis than culture. Histoplasmosis has a patchy and incompletely appreciated distribution around the world especially in South East Asia. We conducted a systematic literature review of cases of all disease forms of histoplasmosis in SE Asia, not including the Indian sub-continent. We also reviewed all histoplasmin skin test mapping studies to determine localities of exposure. We found a total of 407 cases contracted or likely to have been contracted in SE Asia. Numbers of cases by country varied: Thailand (233), Malaysia (76), Indonesia (48) and Singapore (21), with few or no cases reported in other countries. Most cases (255 (63%)) were disseminated histoplasmosis and 177 (43%) cases were HIV associated. Areas of high histoplasmin skin test sensitivity prevalence were found in Myanmar, the Philippines, Indonesia, Thailand and Vietnam - 86.4%, 26.0%, 63.6%, 36.0% and 33.7%, respectively. We have drawn maps of these data. Further study is required to ascertain the extent of histoplasmosis within SE Asia. Diagnostic capability for patients with HIV infection is urgently required in SE Asia, to reduce mortality and mis-diagnosis as tuberculosis.

journal_name

Emerg Microbes Infect

authors

Baker J,Setianingrum F,Wahyuningsih R,Denning DW

doi

10.1080/22221751.2019.1644539

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

1139-1145

issue

1

issn

2222-1751

journal_volume

8

pub_type

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