Histoplasma seropositivity and environmental risk factors for exposure in a general population in Upper River Region, The Gambia: A cross-sectional study
Tessa Rose Cornell,
Bakary Conteh,
Lamin Drammeh,
Foday Jeffang,
Ebrima Sallah,
Alkali Kijera,
Mustapha Jarju,
Mehrab Karim,
Ebrima Khan,
Pa Ousman Ceesay,
Ebrima Manneh,
Dan G. Wootton,
Gina Pinchbeck,
Claire Elizabeth Scantlebury
Affiliations
Tessa Rose Cornell
Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, UK; Corresponding author at: Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, CH64 7TE, UK.
Bakary Conteh
Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
Lamin Drammeh
Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
Foday Jeffang
Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
Ebrima Sallah
Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
Alkali Kijera
Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
Mustapha Jarju
Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
Mehrab Karim
Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
Ebrima Khan
Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
Pa Ousman Ceesay
Gambia Bureau of Statistics (GBoS), Ministry of Finance and Economic Affairs, The Gambia
Ebrima Manneh
Gambia Bureau of Statistics (GBoS), Ministry of Finance and Economic Affairs, The Gambia
Dan G. Wootton
Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, UK; NIHR Health Protection Research Unit in Emerging & Zoonotic Diseases, University of Liverpool, UK
Gina Pinchbeck
Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, UK
Claire Elizabeth Scantlebury
Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, UK
Robust surveillance of Histoplasma species is warranted in endemic regions, including investigation of community-level transmission dynamics. This cross-sectional study explored anti-Histoplasma 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 Histoplasma exposure. One venous blood sample per participant was subject to IMMY Latex Agglutination Histoplasma test to determine presence of a recent IgM response to Histoplasma. Seropositivity risk factors were explored by multi-level, multivariable logistic regression analysis.The study population (n = 298) aged 5–83 years, demonstrated a positively skewed age distribution and comprised 55.4% females. An apparent seroprevalence of 18.8% (n = 56/298, 95% CI 14.5–23.7%) was measured using the LAT. A multivariable model demonstrated increased odds of Histoplasma 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 inside 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 Histoplasma exposure and presents plausible demographic and environmental risk factors for seropositivity. Histoplasma 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).
