Epidemiology and Knowledge Gap of Histoplasmosis in Africa

Abstract

A dimorphic fungus called Histoplasma capsulatum is the cause of the granulomatous disease known as histoplasmosis. Histoplasma capsulatum var. capsulatum (Hcc) and Histoplasma capsulatum var. duboisii (Hcd), 2 variants of this fungus can infect humans and cause, classical or American histoplasmosis and African histoplasmosis, respectively. To improve the knowledge of health professionals, awareness of most fungal diseases, such as histoplasmosis, has been increased in Africa. In this review, we provide an overview of the current status of histoplasmosis in Africa, identify information gaps, and suggest targets for further study. The histoplasmosis literature in medical mycology textbooks and published articles from Google Scholar on histoplasmosis in Africa and the rest of the world were searched and reviewed. There was no restriction on the year of publications Conclusions were drawn from this review. Whereas the Western world has advanced technologies to diagnose histoplasmosis, this is not the case in Africa. Pulmonary histoplasmosis is therefore usually misdiagnosed as pulmonary tuberculosis because it has a similar clinical presentation. Due to a lack of knowledge and diagnostic tools, most national health systems in Africa are unable to correctly diagnose histoplasmosis, leading to misdiagnosis of the disease despite the fact that the continent has a sizable population of HIV/AIDS patients who are susceptible to contracting the illness. Under-recognition and under-diagnosis remain key issues caused by the lack of competent workers and diagnostic facilities. Therefore, this issue must be addressed by coordinated efforts. Also, it is crucial for doctors practicing outside of endemic areas to understand this illness’ symptoms and treatment options. This is especially significant in light of African migration patterns.