Implementation of a Training Course Increased the Diagnosis of Histoplasmosis in Colombia
Diego H Caceres1, Alejandra Zuluaga1, Karen Arango-Bustamante1
1Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia.
Insights
A training program for physicians significantly increased histoplasmosis diagnoses, particularly for individuals with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). This improved diagnostic yield in Colombia.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Public Health
Background:
- Histoplasmosis poses a significant mortality risk, especially for individuals with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in resource-limited settings.
- Limited access to diagnostics and antiretroviral therapy exacerbates histoplasmosis outcomes in developing countries.
Purpose of the Study:
- To evaluate the impact of an educational training program on histoplasmosis diagnosis among physicians in Colombia.
- To assess changes in diagnostic rates following the implementation of the training.
Main Methods:
- 81 physicians across 17 Colombian departments received training on histoplasmosis clinical, epidemiological, and diagnostic aspects.
- Biological samples from suspected cases were analyzed using immunodiagnostic, mycological, and molecular assays between October 2009 and November 2012.
- A total of 1,536 samples from 768 patients were evaluated, including sera, blood, and urine specimens.
Main Results:
- Histoplasmosis was diagnosed in 133 out of 768 patients (17%).
- The number of diagnosed histoplasmosis cases increased from 27 to 44 cases per year after the training program.
- A significant rise in reported histoplasmosis cases was observed post-training.
Conclusions:
- Implementing an educational training program for physicians can significantly improve the diagnosis of histoplasmosis.
- Enhanced diagnostic capacity can lead to earlier detection and potentially better management of histoplasmosis, especially in vulnerable populations like those with HIV/AIDS.
Abstract:
Histoplasmosis causes a significant mortality, especially persons living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) from developing countries where access to both appropriate diagnostic methods and antiretroviral therapy are limited. A total of 81 physicians assigned to 17 Colombian departments (states) received training in the clinical, epidemiological, and diagnostic aspects of histoplasmosis. Once this training was received and during the period of October 2009-November 2012, these physicians sent biological samples for immunodiagnostic, mycological, and molecular tests from their patients with suspicion of histoplasmosis. A total of 1,536 samples from 768 patients were evaluated. Of the 768 patients studied, 463 (60%) were HIV positive, 214 (28%) HIV negative, and in 91 (12%) this diagnosis was unknown, and 538 (70%) were males. The 1,536 specimens studied comprised 722 sera, 439 blood samples, and 241 urines, which were tested by immunodiffusion (ID), culture, and antigenuria, respectively; in addition, 134 specimens were tested by performing a molecular assay. Histoplasmosis was diagnosed in 133 patients (17%). After the training, we observed more diagnoses from 27 to 44 cases per year. In this study, a significantly increased number of histoplasmosis cases reported by year were observed after implementing an educational training program.
