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Published on: May 6, 2021
Association between Histoplasma exposure and stroke
John D Cleary1, Margaret Pearson, Jake Oliver
1School of Pharmacy, University of Mississippi Medical Center, Jackson, MS 39216, USA. jcleary@medicine.umsmed.edu
Summary
Adolescent exposure to Histoplasma capsulatum infection is linked to a higher risk of stroke later in life. This finding may help explain the increased stroke rates in the Southeastern United States stroke belt.
Area of Science:
- Epidemiology
- Infectious Diseases
- Neurology
Background:
- The stroke belt region in the Southeastern US has higher cerebrovascular event rates than the rest of the nation.
- Specific causes for this geographic disparity remain unclear despite research into various risk factors.
- Historical data from 1958-1965 documented adolescent exposure to Histoplasma capsulatum.
Purpose of the Study:
- To investigate the association between adolescent Histoplasma capsulatum exposure and the subsequent development of stroke.
- To explore potential contributing factors to the elevated stroke rates within the stroke belt.
Main Methods:
- A cross-sectional study analyzed medical records of 23,795 US Navy veterans.
- Participants were part of a cooperative skin-testing program (1958-1965) that identified adolescent Histoplasma capsulatum exposure.
- Logistic regression and propensity scores were used to control for confounding variables and estimate stroke risk.
Main Results:
- Adolescent exposure to Histoplasma capsulatum was associated with a 1.34 adjusted odds ratio for stroke (95% CI: 1.1-1.6; P = .0033).
- This increased stroke risk was independent of common cerebrovascular risk factors.
- The model did not control for less frequent risk factors like atrial fibrillation or coronary heart disease.
Conclusions:
- Exposure to Histoplasma capsulatum during adolescence is significantly associated with an increased risk of stroke.
- This finding offers a potential explanation for the higher stroke prevalence in the US stroke belt.
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