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Cornell TR, Jobe D, Donkor S, Wootton DG, Pinchbeck G, Sutherland JS, Scantlebury CE. Histoplasma Seropositivity in TB Patients in The Gambia: Evidence to Drive Research on a High-Priority Fungal Pathogen. Open Forum Infect Dis 2023; 10:ofad510. [PMID: 37901120 PMCID: PMC10603589 DOI: 10.1093/ofid/ofad510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/11/2023] [Indexed: 10/31/2023] Open
Abstract
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.
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Affiliation(s)
- Tessa R Cornell
- Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, UK
| | - Dawda Jobe
- Vaccines and Immunity Theme, MRC Unit The Gambia, London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Simon Donkor
- Vaccines and Immunity Theme, MRC Unit The Gambia, London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Daniel G Wootton
- Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, UK
- NIHR Health Protection Research Unit in Emerging and Zoonotic Diseases, University of Liverpool, Liverpool, UK
| | - Gina Pinchbeck
- Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, UK
| | - Jayne S Sutherland
- Vaccines and Immunity Theme, MRC Unit The Gambia, London School of Hygiene and Tropical Medicine, Fajara, The Gambia
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DIADIE S, NDIAYE M, DIOP K, DIONGUE K, DIOUF J, SARR M, SARR L, LY F, DIENG MT, NIANG SO. [Extrapodal mycetomas in Senegal: epidemiological, clinical and etiological study of 82 cases diagnosed from 2000 to 2020]. MEDECINE TROPICALE ET SANTE INTERNATIONALE 2022; 2:mtsi.v2i1.2022.210. [PMID: 35685836 PMCID: PMC9128459 DOI: 10.48327/mtsi.v2i1.2022.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 01/31/2022] [Indexed: 11/08/2022]
Abstract
Objectives Although the foot remains the main localization of mycetomas, extrapodal attacks, which are rarely studied, are also possible and occur either initially or following an extension. The objectives were to describe the epidemiological, clinical and etiological features of extrapodal mycetomas in Senegal. Methodology Cross-sectional and retrospective study with multicentric enrollment in four reference department, two of which are in dermatology and two in orthopedics and traumatology. We included the files of patients with extrapodal mycetoma followed from January 2000 to December 2020. The data were analysed with SPSS software. Any p less than or equal to 0.05 was statistically significant. Results We collected 82 cases representing 39% of mycetoma cases (n = 210). The average age was 41.9. The sex ratio was 3.1. Professionally, most patients were active farmers in 51% of cases (n = 33), pastoralists and housewives in 9 % (n = 6) respectively. The mean duration of evolution was 7.5 years. Exclusively extrapodal topographies were noted in 84% of cases (n = 69). Foot and extrapodal locations were concomitant in 16% of cases (n = 13). Mycetoma foci were distributed as follows: 59 in the trunk, 47 in the lower limbs, 9 in the upper limbs, 1 in the scalp and 1 in the neck. The etiology was actinomycotic in 46% of cases (n = 38), fungal in 38% (n = 31). It was not specified in 16% of cases (n = 13). Bone involvement occurs after 5 years (p = 0.001) unrelated to the etiology (p = 0.6). Conclusion Extrapodal mycetomas are secondary to direct inoculation. However, extension to bone is exclusively due to diagnostic delay. Periodic consultations in endemic areas combined with training of resident health personnel are necessary for early diagnosis in order to improve the prognosis.
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Affiliation(s)
| | - Maodo NDIAYE
- Service de dermatologie, Centre hospitalier universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Khadim DIOP
- Service de dermatologie, Centre hospitalier universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Khadim DIONGUE
- Service de parasitologie, Centre hospitalier universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Joseph DIOUF
- Service d’orthopédie-traumatologie de l’Hôpital Idrissa Pouye, ex-hôpital général de Grand Yoff (HOGGY), Dakar, Sénégal
| | - Maïmouna SARR
- Service de dermatologie, Centre hospitalier universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Lamine SARR
- Service d’orthopédie-traumatologie, Centre hospitalier universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Fatimata LY
- Service de dermatologie, Institut d’hygiène sociale, Dakar, Sénégal
| | - Mame Thierno DIENG
- Service de dermatologie, Centre hospitalier universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Suzanne Oumou NIANG
- Service de dermatologie, Centre hospitalier universitaire Aristide Le Dantec, Dakar, Sénégal
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Diongue K, Diallo MA, Seck MC, Ndiaye M, Badiane AS, Ndiaye D. The evidence for unavailability of systemic antifungals in Senegal. Ther Adv Infect Dis 2021; 8:20499361211036594. [PMID: 34394929 PMCID: PMC8361555 DOI: 10.1177/20499361211036594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 07/14/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Khadim Diongue
- Service of Parasitology-Mycology, Faculty of
Medicine, Pharmacy and Odontology, Cheikh Anta Diop University, Cheikh Anta
Diop Avenue, Dakar, BO 3005, Senegal
- Laboratory of Parasitology and Mycology,
Aristide Le Dantec University Hospital, Dakar, Senegal
| | - Mamadou Alpha Diallo
- Laboratory of Parasitology and Mycology,
Aristide Le Dantec University Hospital, Dakar, Senegal
| | - Mame Cheikh Seck
- Service of Parasitology-Mycology, Faculty of
Medicine, Pharmacy and Odontology, Cheikh Anta Diop University, Dakar,
Senegal
- Laboratory of Parasitology and Mycology,
Aristide Le Dantec University Hospital, Dakar, Senegal
| | - Mouhamadou Ndiaye
- Service of Parasitology-Mycology, Faculty of
Medicine, Pharmacy and Odontology, Cheikh Anta Diop University, Dakar,
Senegal
- Laboratory of Parasitology and Mycology,
Aristide Le Dantec University Hospital, Dakar, Senegal
| | - Aida Sadikh Badiane
- Service of Parasitology-Mycology, Faculty of
Medicine, Pharmacy and Odontology, Cheikh Anta Diop University, Dakar,
Senegal
- Laboratory of Parasitology and Mycology,
Aristide Le Dantec University Hospital, Dakar, Senegal
| | - Daouda Ndiaye
- Service of Parasitology-Mycology, Faculty of
Medicine, Pharmacy and Odontology, Cheikh Anta Diop University, Dakar,
Senegal
- Laboratory of Parasitology and Mycology,
Aristide Le Dantec University Hospital, Dakar, Senegal
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[Mycoses and antifungals: What is the situation in Senegal in the current context?]. ANNALES PHARMACEUTIQUES FRANÇAISES 2020; 79:440-445. [PMID: 33232707 DOI: 10.1016/j.pharma.2020.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/01/2020] [Accepted: 11/09/2020] [Indexed: 11/24/2022]
Abstract
In the context of increasing incidence of fungal infections worldwide, the availability of antifungal drugs was studied in Senegal, a country with limited resources where diagnosis of invasive fungal infections is not often established by lack of specialists and/or diagnostic tools. After a background on the country's situation with regard to fungal infections and the drug distribution network in Senegal, a compilation of the various available antifungals was presented before concluding with recommendations to prepare for a situation that could allow to treat appropriately invasive mycoses.
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Konan L, Drogba L, Brahima D, Mesfin FB. A Case of Histoplasma duboisii Brain Abscess and Review of the Literature. Cureus 2020; 12:e6984. [PMID: 32201661 PMCID: PMC7075515 DOI: 10.7759/cureus.6984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Histoplasmosis is a fungal disease caused by Histoplasma capsulatum var. capsulatum (Hcc) and H. capsulatum var. duboisii (Hcd). Central nervous system (CNS) involvement is rare. So far, the few cases reported having Histoplasmosis associated brain abscesses were caused by H. capsulatum var. capsulatum. Herein, we report a unique case of brain abscess caused by H. capsulatum var. duboisii occurring in a 42-year-old immunocompromised woman with HIV. Initially, she presented with hypothermia, vomiting, frontal headache, evolving over one month. She then progressed to have a generalized seizure. Brain MRI showed multifocal brain abscesses and a frontal osteitis. The frontal osteitis was biopsied and confirmed the diagnosis of H. capsulatum var. duboisii. She was successfully treated with liposomal amphotericin B (150 mg daily) for the first four weeks and itraconazole (200mg twice daily) for six months.
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Affiliation(s)
- Landry Konan
- Anatomy and Neurosurgery, University Felix Houphouet Boigny, Abidjan, CIV
| | - Landry Drogba
- Neurosurgery, School of Medicine at the University of Abidjan, Abidjan, CIV
| | - Doukoure Brahima
- Pathology, School of Medicine at the University of Abidjan, Abidjan, CIV
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Johannigman TA, Gonzalez O, Dutton JW, Kumar S, Dick EJ. Gingival histoplasmosis: An atypical presentation of African histoplasmosis in three baboons (Papio spp). J Med Primatol 2019; 49:47-51. [PMID: 31595520 DOI: 10.1111/jmp.12443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 08/08/2019] [Accepted: 09/04/2019] [Indexed: 11/29/2022]
Abstract
Gingival lesions as the sole manifestation of African histoplasmosis (Histoplasma capsulatum var. duboisii) have never been reported in baboons. Grossly, lesions can be indistinguishable from bacterial ulcerative gingivitis or gingival hyperplasia. Clinical outcomes of primary gingival histoplasmosis in baboons are unknown and may complicate colony management decisions.
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Affiliation(s)
- Taylor A Johannigman
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, Texas.,The Ohio State University College of Veterinary Medicine, Columbus, Ohio
| | - Olga Gonzalez
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, Texas
| | - John W Dutton
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, Texas
| | - Shyamesh Kumar
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, Texas
| | - Edward J Dick
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, Texas
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Histoplasmosis by Histoplasma capsulatum var. duboisii Observed at the Laboratory of Pathological Anatomy of Lomé in Togo. J Pathog 2017; 2017:2323412. [PMID: 28804654 PMCID: PMC5539941 DOI: 10.1155/2017/2323412] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 06/04/2017] [Indexed: 01/25/2023] Open
Abstract
Our study aimed to describe the epidemiological, clinical, and diagnostic aspects of African histoplasmosis in Togo through a descriptive and cross-sectional study on histological diagnosed African histoplasmosis in Pathology Department of Lomé from 2002 to 2016 (15 years). A total of 17 cases of African histoplasmosis were diagnosed. The sex ratio (M/F) was 1.8. The annual incidence was 1.1 cases. The mean age of the patients was 27.2 ± 0.4 years. All our patients were of social categories with a low socioeconomic level. HIV infection was known in 3 patients and one patient contracted tuberculosis. The clinical manifestations were cutaneous in 7 cases, cutaneous and mucous in 3 cases, cutaneous and lymph node in 3 cases, cutaneous and bone in 2 cases, and disseminated in 2 cases. The samples examined consisted of 14 cutaneous biopsies measuring 2-3 cm and 3 ganglionic biopsies each measuring 4 cm of major axis. Histologically, all cases were of chronic form made of granulomatous reaction with ovoid yeasts measuring between 1 and 2 microns. Despite the low frequency of this disease in our country, it should be kept constantly in mind before any granulomatous lesions, especially in the context of the HIV pandemic.
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Dieng T, Massaly A, Sow D, Vellaissamy S, Sylla K, Tine RC, Dieng Y, Hennequin C. Amplification of blood smear DNA to confirm disseminated histoplasmosis. Infection 2017; 45:687-690. [PMID: 28214953 DOI: 10.1007/s15010-017-0989-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 02/03/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND The prevalence of the Histoplasma capsulatum var. capsulatum (Hcc) histoplasmosis may be underestimated West Africa, both because the diagnosis is not mentioned in the early stages of the disease and due to limited biological resources available. CASE REPORT We report a case of disseminated histoplasmosis due to Hcc in a Senegalese HIV patient. The diagnosis was suspected following the demonstration of small encapsulated yeasts within neutrophils on a thin blood smear. It was further confirmed using a specific real-time PCR applied on a DNA specimen extracted from the thin blood smear. CONCLUSION To the best of our knowledge, this is the first case of Hcc infection diagnosed in Senegal. Blood smear may be a valuable screening tool in the case of bloodstream dissemination and can be used for further molecular approaches to confirm the diagnosis.
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Affiliation(s)
- T Dieng
- Service de Parasitologie-Mycologie, Faculté de Médecine, Université Cheikh Anta Diop, 5005, Dakar, Sénégal.,Service de Parasitologie-Mycologie, Centre Hospitalier National Universitaire de Fann, Dakar, Sénégal
| | - A Massaly
- Service des Maladies Infectieuses, Centre Hospitalier National Universitaire de Fann, Dakar, Sénégal
| | - D Sow
- Service de Parasitologie-Mycologie, Faculté de Médecine, Université Cheikh Anta Diop, 5005, Dakar, Sénégal.,Service de Parasitologie-Mycologie, Centre Hospitalier National Universitaire de Fann, Dakar, Sénégal
| | - S Vellaissamy
- Service de Parasitologie-Mycologie, Assistance Publique-Hôpitaux de Paris, Hôpital St Antoine, 34 rue Crozatier, 75012, Paris, France
| | - K Sylla
- Service de Parasitologie-Mycologie, Faculté de Médecine, Université Cheikh Anta Diop, 5005, Dakar, Sénégal.,Service de Parasitologie-Mycologie, Centre Hospitalier National Universitaire de Fann, Dakar, Sénégal
| | - R C Tine
- Service de Parasitologie-Mycologie, Faculté de Médecine, Université Cheikh Anta Diop, 5005, Dakar, Sénégal.,Service de Parasitologie-Mycologie, Centre Hospitalier National Universitaire de Fann, Dakar, Sénégal
| | - Y Dieng
- Service de Parasitologie-Mycologie, Faculté de Médecine, Université Cheikh Anta Diop, 5005, Dakar, Sénégal.,Service de Parasitologie-Mycologie, Centre Hospitalier National Universitaire de Fann, Dakar, Sénégal
| | - C Hennequin
- Service de Parasitologie-Mycologie, Assistance Publique-Hôpitaux de Paris, Hôpital St Antoine, 34 rue Crozatier, 75012, Paris, France. .,Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR S 1135, CNRS ERL 8255, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), 91 Bd de l'hôpital, 75013, Paris, France.
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