Histoplasma Seropositivity in TB Patients in The Gambia: Evidence to Drive Research on a High-Priority Fungal
Tessa R Cornell1, Dawda Jobe2, Simon Donkor2
1Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, UK.
Background:
Inclusion of Histoplasma in the World Health Organization's first Fungal Priority Pathogens List under "high-priority" fungal species highlights the need for robust surveillance of Histoplasma spp. in endemic and underrepresented regions. Despite increasing reports of histoplasmosis in Africa, data on the burden of this fungal disease are sparse in The Gambia. This baseline study examined the human seroprevalence of anti-Histoplasma antibody in a TB patient group in The Gambia, explored associations between seropositivity and demographic and clinical variables, and proposes future research directions.
Methods:
Biobanked plasma samples were selected from active TB cases with variable HIV infection status. Latex agglutination tests were performed on samples from 52 study participants to detect the presence of anti-Histoplasma antibodies. Potential risk factors for Histoplasma exposure were explored using logistic regression analysis.
Results:
The sample seroprevalence of anti-Histoplasma antibody was 28.8% (n = 15/52; 95% CI, 17.1%-43.1%). Multivariable logistic regression analysis identified a statistically significant association between Histoplasma seropositivity and age (odds ratio, 0.91; 95% CI, 0.84-0.98; P = .008).
Conclusions:
This baseline study provides evidence of Histoplasma seropositivity in TB patients in The Gambia and explores risk factors for exposure. The small sample size and use of the LAT in TB and HIV-positive patient groups are significant study limitations. Future research directions are proposed to ascertain the burden of Histoplasma in general and patient populations and explore the context-specific risk factors for exposure and infection in The Gambia.
Insights
This study found a 28.8% seroprevalence of anti-Histoplasma antibodies in Gambian TB patients, with older age linked to higher exposure risk. Further research is needed to understand Histoplasma burden and risk factors in The Gambia.
Area of Science:
- Mycology
- Infectious Diseases
- Epidemiology
Background:
- Histoplasma is a high-priority fungal pathogen requiring robust surveillance, especially in underrepresented regions.
- Data on the burden of histoplasmosis in The Gambia are scarce, despite increasing reports in Africa.
- This study addresses the need for baseline data on Histoplasma exposure in The Gambia.
Purpose of the Study:
- To determine the seroprevalence of anti-Histoplasma antibodies in tuberculosis (TB) patients in The Gambia.
- To explore demographic and clinical factors associated with Histoplasma seropositivity.
- To propose future research directions for understanding Histoplasma burden and risk factors.
Main Methods:
- Selected biobanked plasma samples from 52 active TB cases with varying HIV status.
- Utilized latex agglutination tests (LAT) to detect anti-Histoplasma antibodies.
- Employed logistic regression analysis to explore potential risk factors for Histoplasma exposure.
Main Results:
- A sample seroprevalence of 28.8% (15/52) for anti-Histoplasma antibodies was observed.
- Multivariable logistic regression revealed a significant association between Histoplasma seropositivity and older age (OR, 0.91; P = .008).
Conclusions:
- This baseline study provides initial evidence of Histoplasma seropositivity among TB patients in The Gambia.
- Study limitations include a small sample size and the use of LAT in TB and HIV-positive individuals.
- Further research is recommended to ascertain the full burden of Histoplasma and identify specific risk factors in The Gambia.
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