Volume 93, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Histoplasmosis causes a significant mortality, especially persons living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) from developing countries where access to both appropriate diagnostic methods and antiretroviral therapy are limited. A total of 81 physicians assigned to 17 Colombian departments (states) received training in the clinical, epidemiological, and diagnostic aspects of histoplasmosis. Once this training was received and during the period of October 2009–November 2012, these physicians sent biological samples for immunodiagnostic, mycological, and molecular tests from their patients with suspicion of histoplasmosis. A total of 1,536 samples from 768 patients were evaluated. Of the 768 patients studied, 463 (60%) were HIV positive, 214 (28%) HIV negative, and in 91 (12%) this diagnosis was unknown, and 538 (70%) were males. The 1,536 specimens studied comprised 722 sera, 439 blood samples, and 241 urines, which were tested by immunodiffusion (ID), culture, and antigenuria, respectively; in addition, 134 specimens were tested by performing a molecular assay. Histoplasmosis was diagnosed in 133 patients (17%). After the training, we observed more diagnoses from 27 to 44 cases per year. In this study, a significantly increased number of histoplasmosis cases reported by year were observed after implementing an educational training program.


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  1. Colombo AL, Tobon A, Restrepo A, Queiroz-Telles F, Nucci M, , 2011. Epidemiology of endemic systemic fungal infections in Latin America. Med Mycol 49: 785798. [Google Scholar]
  2. Knox KS, Hage CA, , 2010. Histoplasmosis. Proc Am Thorac Soc 7: 169172.[Crossref] [Google Scholar]
  3. Goodwin RA, Loyd JE, Prez RMD, , 1981. Histoplasmosis in normal hosts. Medicine (Baltimore) 4: 231266.[Crossref] [Google Scholar]
  4. Wheat J, , 1995. Endemic mycoses in AIDS: a clinical review. Clin Microbiol Rev 8: 146159. [Google Scholar]
  5. Deepe GS, Bennett JE, Dolin R, Blaser MJ, , 2015. Histoplasma capsulatum. , eds. Principles and Practice of Infectious Diseases. Philadelphia, PA: Elsevier, 29492962. [Google Scholar]
  6. Cáceres DH, Gómez BL, Restrepo Á, Tobón ÁM, , 2012. Histoplasmosis y sida: factores de riesgo clínico y de laboratorio asociados al pronóstico de la enfermedad. Infectio 16 (Suppl 3): 4450.[Crossref] [Google Scholar]
  7. Desai SS, Wong B, Hospenthal DR, Rinaldi MG, , 2007. Diagnostic immunology. , eds. Diagnosis and Treatment of Human Mycoses. Totowa, NJ: Humana Press, 5380. [Google Scholar]
  8. Kauffman CA, , 2007. Histoplasmosis: a clinical and laboratory update. Clin Microbiol Rev 20: 115132.[Crossref] [Google Scholar]
  9. Scheel CM, Gómez BL, , 2014. Diagnostic methods for histoplasmosis: focus on endemic countries with variable infrastructure levels. Curr Trop Med Rep 1: 129137. [Google Scholar]
  10. Nacher M, Adenis A, Mc Donald S, Do Socorro Mendonca Gomes M, Singh S, Lopes Lima I, Malcher Leite R, Hermelijn S, Wongsokarijo M, Van Eer M, Marques Da Silva S, Mesquita Da Costa M, Silva M, Calvacante M, do Menino Jesus Silva Leitao T, Gómez BL, Restrepo A, Tobon A, Canteros CE, Aznar C, Blanchet D, Vantilcke V, Vautrin C, Boukhari R, Chiller T, Scheel C, Ahlquist A, Roy M, Lortholary O, Carme B, Couppié P, Vreden S, , 2013. Disseminated histoplasmosis in HIV-infected patients in South America: a neglected killer continues on its rampage. PLoS Negl Trop Dis 7: e2319.[Crossref] [Google Scholar]
  11. Carmona-Fonseca J, , 1971. Análisis estadístico y ecológico-epidemiológico de la sensibilidad a la histoplasmina en Colombia 1950–1968. Antioquia Med 21: 109154. [Google Scholar]
  12. Arango M, Castañeda E, Agudelo CI, De Bedout C, Agudelo CA, Tobón A, Linares M, Valencia Y, Restrepo A, Colombian Histoplasmosis Study Group; , 2011. Histoplasmosis: results of the Colombian National Survey, 1992–2008. Biomedica 31: 344356.[Crossref] [Google Scholar]
  13. Arango-Bustamante K, Restrepo A, Cano LE, Bedout C, Tobón AM, González A, , 2013. Diagnostic value of culture and serological tests in the diagnosis of histoplasmosis in HIV and non-HIV Colombian patients. Am J Trop Med Hyg 89: 937942.[Crossref] [Google Scholar]
  14. De Pauw B, Walsh TJ, Donnelly JP, Stevens DA, Edwards JE, Calandra T, Pappas PG, Maertens J, Lortholary O, Kauffman CA, Denning DW, Patterson TF, Maschmeyer G, Bille J, Dismukes WE, Herbrecht R, Hope WW, Kibbler CC, Kullberg BJ, Marr KA, Muñoz P, Odds FC, Perfect JR, Restrepo A, Ruhnke M, Segal BH, Sobel JD, Sorrell TC, Viscoli C, Wingard JR, Zaoutis T, Bennett JE, European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group, National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group; , 2008. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 46: 18131821.[Crossref] [Google Scholar]
  15. Muñoz C, Gómez BL, Tobón A, Arango K, Restrepo A, Correa MM, Muskus C, Cano LE, González A, , 2010. Validation and clinical application of a molecular method for identification of Histoplasma capsulatum in human specimens in Colombia, South America. Clin Vaccine Immunol 17: 6267.[Crossref] [Google Scholar]
  16. Kaufman M, Huppert CF, Netto L, Pollak A, Restrepo A, , 1974. Manual of Standardized Serodiagnostic Procedures for Systemic Mycoses. Part 2: Complement Fixation Tests. Washington, DC: Departmant of Research, Development and Coordination, Pan American Health Organization. [Google Scholar]
  17. Kaufman L, Huppert M, Fava-Neto C, Negroni R, Restrepo A, , 1974. Manual of Standardized Serodiagnostic Procedures for Systemic Mycosis Part I: Agar Gel Immunodiffusion Tests. Washington, DC: Departmant of Research, Development and Coordination, Pan American Health Organization. [Google Scholar]
  18. Lindsley MD, Morrison CJ, Warnock DW, Detrick B, Hamilton RJ, , 2007. Serological and molecular diagnosis of fungal infections. , eds. Manual of Molecular and Clinical Laboratory Immunology, 7th edition. Washington, DC: ASM Press, 569605. [Google Scholar]
  19. Caceres DH, Scheel CM, Tobón AM, Ahlquist Cleveland A, Restrepo A, Brandt ME, Chiller T, Gómez BL, , 2014. Validation of an enzyme-linked immunosorbent assay that detects Histoplasma capsulatum antigenuria in Colombian patients with AIDS for diagnosis and follow-up during therapy. Clin Vaccine Immunol 9: 13641368.[Crossref] [Google Scholar]
  20. Lopes-Mori FM, Mitsuka-Breganó R, Capobiango JD, Inoue IT, Reiche EM, Morimoto HK, Casella AM, Bittencourt LH, Freire RL, Navarro IT, , 2011. Programs for control of congenital toxoplasmosis. Rev Assoc Med Bras 57: 594599.[Crossref] [Google Scholar]
  21. Golding GR, Quinn B, Bergstrom K, Stockdale D, Woods S, Nsungu M, Brooke B, Levett PN, Horsman G, McDonald R, Szklarczuk B, Silcox S, Paton S, Carson M, Mulvey MR, Irvine J, Northern Antibiotic Resistance Partnership; , 2012. Community-based educational intervention to limit the dissemination of community-associated methicillin-resistant Staphylococcus aureus in northern Saskatchewan, Canada. BMC Public Health 6: 1215. [Google Scholar]
  22. Masanza MM, Nqobile N, Mukanga D, Gitta SN, , 2010. Laboratory capacity building for the International Health Regulations (IHR[2005]) in resource-poor countries: the experience of the African Field Epidemiology Network (AFENET). BMC Public Health 10 (Suppl 1): S8.[Crossref] [Google Scholar]
  23. Monday B, Gitta SN, Wasswa P, Namusisi O, Bingi A, Musenero M, Mukanga D, , 2011. Paradigm shift: contribution of field epidemiology training in advancing the “One Health” approach to strengthen disease surveillance and outbreak investigations in Africa. Pan Afr Med J 10 (Suppl 1): 13. [Google Scholar]
  24. Mukanga D, Tshimanga M, Wurapa F, Binka F, Serwada D, Bazeyo W, Pariyo G, Wabwire-Mangen F, Gitta S, Chungong S, Trostle M, Nsubuga P, , 2011. The genesis and evolution of the African Field Epidemiology Network. Pan Afr Med J 10 (Suppl 1): 2. [Google Scholar]
  25. Mosha F, Oundo J, Mukanga D, Njenga K, Nsubuga P, , 2011. Public health laboratory systems development in east Africa through training in laboratory management and field epidemiology. Pan Afr Med J 10 (Suppl 1): 14. [Google Scholar]
  26. Kuonza L, Tint KS, Harris B, Nabukenya I, , 2011. Public health systems strengthening in Africa: the role of South Africa Field Epidemiology and Laboratory Training Programme. Pan Afr Med J 10 (Suppl 1): 8. [Google Scholar]
  27. Wakai K, Matsuo K, , 2007. The JICA training course, community-based cancer prevention for the Asian and Pan-Pacific countries, fiscal year 2006 (epidemiological approach). Asian Pac J Cancer Prev 8: 150154. [Google Scholar]
  28. SIVIGILA Instituto Nacional de Salud (INS), 2014. Boletín epidemiológico semana 14 del año 2014. Available at: http://www.ins.gov.co/boletin-epidemiologico/Boletn%20Epidemiolgico/2014%20Boletin%20epidemiologico%20semana%2014.pdf. Accessed April 7, 2014. [Google Scholar]
  29. Palacio D, Rodríguez C, Cuervo C, Echeverri R, Mendez C, Urquijo L, , 2010. Informe UNGASS-2010. Seguimiento de la Declaración de compromiso sobre el VIH/sida, Informe Nacional, Republica de Colombia. Available at: http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2010countries/colombia_2010_country_progress_report_en.pdf. Accessed March 8, 2010. [Google Scholar]

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Supplementary PDF

  • Received : 06 Feb 2015
  • Accepted : 02 May 2015
  • Published online : 02 Sep 2015

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