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Current epidemiology of histoplasmosis in Nigeria: A systematic review and meta-analysis
Bassey Ewa Ekeng1, Adeyinka Afolake Davies2, Iriagbonse Iyabo Osaigbovo3, Ubleni Ettah Emanghe4, Ubong Aniefiok Udoh5, Mary Adanma Alex-Wele6, Oluwaseun Chinaza Adereti7, Rita Okeoghene Oladele8
1 Department of Medical Microbiology and Parasitology, University of Calabar Teaching Hospital, Calabar; Medical Mycology Society of Nigeria, Lagos, Nigeria
2 Medical Mycology Society of Nigeria, Lagos; Department of Medical Microbiology and Parasitology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
3 Medical Mycology Society of Nigeria, Lagos; Department of Medical Microbiology, School of Medicine, College of Medical Sciences, University of Benin, Benin City, Nigeria
4 Department of Medical Microbiology and Parasitology, University of Calabar Teaching Hospital; Department of Medical Microbiology and Parasitology, Faculty of Basic Clinical Sciences, College of Medical Sciences, University of Calabar, Calabar, Nigeria
5 Department of Medical Microbiology and Parasitology, University of Calabar Teaching Hospital, Calabar; Medical Mycology Society of Nigeria, Lagos; Department of Medical Microbiology and Parasitology, Faculty of Basic Clinical Sciences, College of Medical Sciences, University of Calabar, Calabar, Nigeria
6 Medical Mycology Society of Nigeria, Lagos; Department of Medical Microbiology and Parasitology, University of Port-Harcourt Teaching Hospital, Port-Harcourt, Nigeria
7 Department of Medical Microbiology and Parasitology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
8 Medical Mycology Society of Nigeria; Department of Medical Microbiology and Parasitology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
Correspondence Address:
Bassey Ewa Ekeng
University of Calabar Teaching Hospital, Calabar
Nigeria
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/npmj.npmj_311_22
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Introduction: Histoplasmosis commonly occurs in the advanced HIV disease population and also in immunocompetent individuals. Previous reviews and recent studies highlight several cases of histoplasmosis reported in Nigeria. We aimed to describe the current epidemiology of histoplasmosis in Nigeria and the need for active surveillance in the at-risk populations. Methods: Literature searches for all publications on histoplasmosis in Nigeria were performed using online databases including Google scholar, PubMed and African Journal online. The following search terms: 'histoplasmosis' and 'Nigeria', AND/OR 'Histoplasma and Nigeria' were used. No limitations on the date or other search criteria were applied, to avoid the exclusion of articles on histoplasmosis in Nigeria. All publications on histoplasmosis outside Nigeria were excluded. Results: Our review identified a total of 231 cases of histoplasmosis reported from Nigeria: 128 were from individual case reports and case series while 103 were cases from two observational studies. Of the 231 cases, 97 (42.0%) were from South West Nigeria, 66 (28.6%) were from South-South Nigeria, 24 (10.4%) were from North West, 22 (9.5%) from North Central Nigeria, 17 (7.4%) from South East Nigeria and 5 (2.2%) from the North East. Based on Nigeria's current population size of 216,953,585 the burden of histoplasmosis per 100,000 inhabitants was estimated to be 0.1%. The sheer number of cases detected in recent observational studies compared with individual case reports and series reported over a longer duration of 6 decades suggests gross under-reporting of histoplasmosis in Nigeria. Conclusion: Histoplasmosis is not an uncommon clinical entity in Nigeria. Histoplasmosis case finding should be improved by training and retraining healthcare professionals and providing much-needed diagnostic capacity and infrastructure across health facilities in Nigeria.
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