Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
J Microbiol Methods. 2021 Jun;185:106226. doi: 10.1016/j.mimet.2021.106226. Epub 2021 Apr 18.
Acute disseminated histoplasmosis (ADH) is an AIDS-defining illness and reported in Cameroon, but there are few data about its incidence. Between June and August 2019, we conducted a descriptive cross-sectional study to screen for histoplasmosis in a population of adults with HIV infection, irrespective of their CD4 T-cell counts, using Histoplasma urine antigen detection enzyme immunoassay (EIA) and histoplasmin skin test. Of the 138 participants screened, 36 (26%) had detectable antigen in urine, using an OD cut off of 0.045. Skin lesions were present in two (6%) cases. Of 39 patients tested for histoplasmin skin test positivity, one was positive. Histoplasma antigenuria was associated with a positive history of chest infection (Odds ratio: 3.632, 95% confidence interval: 1.635-8.071, p= 0.001). As 30 (21.7%) of titres were between 0.045 (the current cut off) and 0.25, the cut off may need adjustment in Cameroon, using disease confirmation with alternative, highly sensitive diagnostic approaches such as PCR and bone marrow examination. H. capsulatum infection appears to be common among HIV-infected patients attending outpatient clinics at the Buea Regional Hospital. There is an acute need to improve awareness and management of HIV patients with respect to H. capsulatum infection.
急性播散性组织胞浆菌病 (ADH) 是一种艾滋病定义性疾病，在喀麦隆有报道，但关于其发病率的数据很少。2019 年 6 月至 8 月，我们开展了一项描述性横断面研究，使用组织胞浆菌尿液抗原检测酶免疫分析 (EIA) 和组织胞浆菌素皮肤试验，对无论 CD4 T 细胞计数如何的 HIV 感染成年人群进行组织胞浆菌病筛查。在筛查的 138 名参与者中，36 名（26%）的尿液中可检测到抗原，OD 截断值为 0.045。有 2 例（6%）出现皮肤损伤。在 39 名接受组织胞浆菌素皮肤试验阳性检测的患者中，有 1 名阳性。组织胞浆菌抗原尿与胸部感染阳性史相关（优势比：3.632，95%置信区间：1.635-8.071，p=0.001）。由于 30 份（21.7%）滴度在 0.045（当前截断值）和 0.25 之间，因此可能需要在喀麦隆调整截断值，使用替代的、高度敏感的诊断方法，如 PCR 和骨髓检查来确认疾病。荚膜组织胞浆菌感染在比奥亚地区医院门诊就诊的 HIV 感染患者中似乎很常见。迫切需要提高对 HIV 患者荚膜组织胞浆菌感染的认识和管理。
