title: Seroprevalence of histoplasmosis in Kampala, Uganda.
abstract: Histoplasmosis is endemic to the Midwestern United States, but cases have been reported nearly worldwide. A 1970 study found 3.8% skin test sensitivity to Histoplasma capsulatum in Uganda but no systemic study of histoplasmosis exposure has occurred since the onset of the human immunodeficiency virus (HIV) pandemic. This study investigated the seroprevalence of H. capsulatum and sought previously undetected cases of histoplasmosis in Kampala, Uganda. Serum, cerebrospinal fluid (CSF) and/or urine specimens were obtained from HIV-infected persons with suspected meningitis. Specimens were tested for H. capsulatum IgG and IgM by enzyme immune assay and Histoplasma antigen. 147 of the 257 subjects who were enrolled had cryptococcal meningitis. Overall, 1.3% (2/151) of subjects were serum Histoplasma IgG positive, and zero of 151 were IgM positive. Antigen was not detected in any serum (n = 57), urine (n = 37, or CSF (n = 63) samples. Both subjects with serum Histoplasma IgG positivity had cryptococcal meningitis. Histoplasma capsulatum IgG was detected at low levels in persons with HIV/AIDS in Kampala, Uganda. Histoplasmosis is not widespread in Uganda but microfoci do exist. There appears to be no cross-reactivity between Cryptococcus neoformans and Histoplasma antigen testing, and cryptococcosis appears to be at most, a rare cause of positive Histoplasma IgG.
authors.affiliation: Infectious Diseases Institute, Makerere University, Kampala, Uganda Department of Medicine, University of Minnesota, Minneapolis, Minnesota Center for Infectious Disease & Microbiology Translational Research, University of Minnesota, Minneapolis, Minnesota nate.bahr@gmail.com.
authors.forename: Nathan C
authors.initials: NC
authors.lastname: Bahr
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, Minnesota Department of Medicine, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota.
authors.forename: George A
authors.initials: GA
authors.lastname: Sarosi
authors.affiliation: Infectious Diseases Institute, Makerere University, Kampala, Uganda Department of Medicine, University of Minnesota, Minneapolis, Minnesota Center for Infectious Disease & Microbiology Translational Research, University of Minnesota, Minneapolis, Minnesota School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: David B
authors.initials: DB
authors.lastname: Meya
authors.affiliation: Infectious Diseases Institute, Makerere University, Kampala, Uganda Department of Medicine, University of Minnesota, Minneapolis, Minnesota Center for Infectious Disease & Microbiology Translational Research, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Bohjanen
authors.affiliation: MiraVista Diagnostics, Indianapolis, Indiana.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Richer
authors.affiliation: MiraVista Diagnostics, Indianapolis, Indiana.
authors.forename: Samantha
authors.initials: S
authors.lastname: Swartzentruber
authors.affiliation: Center for Infectious Disease & Microbiology Translational Research, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Ryan
authors.initials: R
authors.lastname: Halupnick
authors.affiliation: MiraVista Diagnostics, Indianapolis, Indiana.
authors.forename: Deidre
authors.initials: D
authors.lastname: Jarrett
authors.affiliation: MiraVista Diagnostics, Indianapolis, Indiana.
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Wheat
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, Minnesota Center for Infectious Disease & Microbiology Translational Research, University of Minnesota, Minneapolis, Minnesota.
authors.forename: David R
authors.initials: DR
authors.lastname: Boulware
mesh_terms: D000328:Adult; D000908:Antibodies, Fungal / Q000032:analysis; D002555:Cerebrospinal Fluid / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000150:complications; D006660:Histoplasmosis / Q000453:epidemiology*; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D008297:Male; D011446:Prospective Studies; D016036:Seroepidemiologic Studies; D044967:Serum / Q000276:immunology; D014454:Uganda / Q000453:epidemiology; D014556:Urine / Q000737:chemistry
chemical_list: D000908:Antibodies, Fungal; D007074:Immunoglobulin G; D007075:Immunoglobulin M
keywords: Diagnostic Techniques and Procedures; Histoplasmosis; Histoplasmosis capsulatum; Human Immunodeficiency Virus; Validation Studies; seroepidemiologic studies