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Histoplasmin Sensitivity in Indonesia¹

To obtain information on the prevalence of histoplasmin sensitivity in Indonesia and its relation to radiographic evidence of pulmonary calcifications, a preliminary survey including simultaneous skin-testing with histoplasmin and tuberculin and X-ray examination of the chest was carried out in Djakarta Java in 1953–54. The study population comprised a total of 2,542 persons—795 university students, 267 patients in a general hospital, 458 nurses and 1022 schoolchildren.

The survey results indicate that skin sensitivity to histoplasmin is at least moderately prevalent in Indonesia; 2.7 per cent in the school-age group and from 9 to 12 per cent in the adult groups had sizable reactions to histoplasmin (6 mm. or more of induration). In all four groups the percentage was somewhat higher for the males than for the females. Among the nurses and the students those coming from West Sumatra had the highest percentage of positive histoplasmin reactions and those coming from North Java the lowest; the difference, however, was not very marked. The simultaneous tuberculin test was negative in about one-third of the histoplasmin reactors.

Out of a total of 2,311 persons X-rayed, only 25 or 1.1 per cent had pulmonary calcifications. For the adult groups the corresponding percentage was 1.5. Almost all of the calcifications were found in persons positive to tuberculin, yet the proportion of calcifications was higher among those positive to both tuberculin and histoplasmin than among those positive to tuberculin only. This suggests that histoplasmosis as well as tuberculosis is a cause of pulmonary calcification in Indonesia.

¹ This work was aided by a grant from the Stichting Vereniging tot Bevordering van de Geneeskundige Wetenschappen in Indonesia.

² Present address: Tuberculosis Program, U. S. Public Health Service, Washington 25, D. C.

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