<i>Histoplasma</i> seropositivity and environmental risk factors for exposure in a general population in Upper River Region, The Gambia: A cross-sectional study.


Cornell, Tessa Rose ORCID: 0000-0002-2304-8555, Conteh, Bakary ORCID: 0000-0003-0701-2701, Drammeh, Lamin, Jeffang, Foday, Sallah, Ebrima, Kijera, Alkali, Jarju, Mustapha, Karim, Mehrab, Khan, Ebrima, Ceesay, Pa Ousman et al (show 5 more authors) (2024) <i>Histoplasma</i> seropositivity and environmental risk factors for exposure in a general population in Upper River Region, The Gambia: A cross-sectional study. One health (Amsterdam, Netherlands), 18. 100717-.

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Abstract

Robust surveillance of <i>Histoplasma</i> species is warranted in endemic regions, including investigation of community-level transmission dynamics. This cross-sectional study explored anti-<i>Histoplasma</i> antibody seroprevalence and risk factors for exposure in a general population in Upper River Region (URR), The Gambia. Study participants were recruited (December 2022-March 2023) by random household sampling across 12 Enumeration Areas (EAs) of URR. A questionnaire and clinical examination were performed; exploring demographic, clinical and environmental risk factors for <i>Histoplasma</i> exposure. One venous blood sample per participant was subject to IMMY Latex Agglutination <i>Histoplasma</i> test to determine presence of a recent IgM response to <i>Histoplasma</i>. Seropositivity risk factors were explored by multi-level, multivariable logistic regression analysis. The study population (<i>n</i> = 298) aged 5-83 years, demonstrated a positively skewed age distribution and comprised 55.4% females. An apparent seroprevalence of 18.8% (<i>n</i> = 56/298, 95% CI 14.5-23.7%) was measured using the LAT. A multivariable model demonstrated increased odds of <i>Histoplasma</i> seropositivity amongst female participants (OR = 2.41 95% CI 1.14-5.10); and participants reporting involvement in animal manure management (OR = 4.21 95% CI 1.38-12.90), and management of domestic animals <i>inside</i> the compound at night during the dry season (OR = 10.72 95% CI 2.02-56.83). Increasing age (OR = 0.96 95% CI 0.93-0.98) was associated with decreased odds of seropositivity. Clustering at EA level was responsible for 17.2% of seropositivity variance. The study indicates frequent recent <i>Histoplasma</i> exposure and presents plausible demographic and environmental risk factors for seropositivity. <i>Histoplasma</i> spp. characterisation at this human-animal-environment interface is warranted, to determine public health implications of environmental reservoirs in The Gambia. The study was supported by Wellcome Trust (206,638/Z/17/Z to CES) and a University of Liverpool-funded PhD studentship (to TRC).

Item Type: Article
Uncontrolled Keywords: Regional Health Directorate Upper River Region
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 05 Apr 2024 09:19
Last Modified: 12 Apr 2024 15:37
DOI: 10.1016/j.onehlt.2024.100717
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3180098
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