1. HIV-Associated Histoplasmosis Early Mortality and Incidence Trends: From Neglect to Priority.: HIV - associated histoplasmosis early mortality
- Author
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Matthieu Hanf, Magalie Demar, Christine Aznar, Antoine Adenis, Rachida Boukhari, Vincent Vantilcke, Denis Blachet, Bernard Carme, Pierre Couppié, Mathieu Nacher, Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Epidémiologie des parasitoses et mycoses tropicales, Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Médecine Interne, Centre Hospitalier de l'Ouest Guyanais, Laboratoire de Biologie Médicale, Centre Hospitalier de l'Ouest Guyanais Franck Joly (Saint-Laurent-du-Maroni), Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Université des Antilles (UA)-Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and Service de Dermatologie et Vénérologie
- Subjects
Male ,Viral Diseases ,Antifungal Agents ,Epidemiology ,Medicine and Health Sciences ,Young adult ,Histoplasmosis ,0303 health sciences ,lcsh:Public aspects of medicine ,Incidence (epidemiology) ,Mortality rate ,Incidence ,Fungal Diseases ,Middle Aged ,3. Good health ,Histoplasma capsulatum ,French Guiana ,Death ,AIDS ,Infectious Diseases ,Female ,Research Article ,Neglected Tropical Diseases ,Adult ,medicine.medical_specialty ,lcsh:Arctic medicine. Tropical medicine ,Infectious Disease Control ,lcsh:RC955-962 ,Sexually Transmitted Diseases ,03 medical and health sciences ,Young Adult ,Acquired immunodeficiency syndrome (AIDS) ,medicine ,Humans ,030304 developmental biology ,Retrospective Studies ,AIDS-Related Opportunistic Infections ,030306 microbiology ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,HIV ,lcsh:RA1-1270 ,Retrospective cohort study ,medicine.disease ,Tropical Diseases ,Immunology ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Demography - Abstract
Background Histoplasmosis is an endemic fungal infection in French Guiana. It is the most common AIDS-defining illness and the leading cause of AIDS-related deaths. Diagnosis is difficult, but in the past 2 decades, it has improved in this French overseas territory which offers an interesting model of Amazonian pathogen ecology. The objectives of the present study were to describe the temporal trends of incidence and mortality indicators for HIV-associated histoplasmosis in French Guiana. Methods A retrospective study was conducted to describe early mortality rates observed in persons diagnosed with incident cases of HIV-associated Histoplasma capsulatum var. capsulatum histoplasmosis admitted in one of the three main hospitals in French Guiana between 1992 and 2011. Early mortality was defined by death occurring within 30 days after antifungal treatment initiation. Data were collected on standardized case report forms and analysed using standard statistical methods. Results There were 124 deaths (45.3%) and 46 early deaths (16.8%) among 274 patients. Three time periods of particular interest were identified: 1992–1997, 1998–2004 and 2005–2011. The two main temporal trends were: the proportion of early deaths among annual incident histoplasmosis cases significantly declined four fold (χ2, p, Author Summary Histoplasmosis is an endemic fungal infection in French Guiana. It is the most common AIDS-defining illness and the leading cause of AIDS-related deaths. Diagnosis is difficult, but in the past 2 decades, it has improved. The objectives of the present study were to describe the temporal trends of incidence and mortality indicators for HIV-associated histoplasmosis in French Guiana. A retrospective study was conducted to describe early mortality rates observed in persons diagnosed with incident cases of HIV-associated histoplasmosis admitted in one of the three main hospitals of French Guiana between 1992 and 2011. Early mortality was defined by death occurring within 30 days after antifungal treatment initiation. Data were collected on standardized case report forms and analysed using standard statistical methods. Among 274 patients there were 46 early deaths (16.8%). The two main temporal trends were: the proportion of early deaths significantly divided four fold and the number of annual incident histoplasmosis cases increased three fold. The present example testifies that rapid progress could be at reach if awareness increases and leads to clinical and laboratory capacity building in order to diagnose and treat this curable disease.
- Published
- 2014
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