Histoplasmosis Misdiagnosed as TB in Nigerian Children: Urgent Need for Cost-Effective Diagnostics

Strategic Insights -

Research in Nigeria has highlighted the urgent need for cost-effective and accessible diagnostics in resource-limited settings to improve pediatric care. A study published in the Journal of Tropical Pediatrics found that histoplasmosis, a fungal infection, is often misdiagnosed as tuberculosis (TB) in Nigerian children. The study, conducted across three sites in Nigeria, revealed that 2 out of 100 sampled participants tested positive for Histoplasma antigen, indicating a significant prevalence of histoplasmosis in Nigerian children presenting with symptoms mimicking TB.

Key Takeaways:

  • Histoplasmosis is a critical differential diagnosis in regions with a high TB burden, particularly in low- and middle-income countries (LMIC).
  • Case series from Nigeria show histoplasmosis is commonly misdiagnosed as TB in pediatric populations.
  • The study investigated Nigerian children with presumptive TB for histoplasmosis using Histoplasma antigen assay and found a 2% prevalence of histoplasmosis in the sampled population.
  • The Histoplasma antigen assay (MiraVista lateral flow assay) was found to be more efficient in detecting histoplasmosis compared to the Clarus IMMY ELISA.
  • The research highlights the urgent need for cost-effective and accessible diagnostics in resource-limited settings to improve pediatric care.
  • Additional research is required to validate Histoplasma antigen assay diagnostics in children.

Statistics:

  • 100 participants were recruited in the study, with 73 being unconfirmed cases of TB, 27 confirmed TB cases, and 21 participants with advanced HIV disease.
  • 2 out of 100 sampled participants tested positive for Histoplasma antigen, indicating a 2% prevalence of histoplasmosis.
  • The study was a descriptive cross-sectional study conducted across pediatric TB clinics in three sites in Nigeria.

Sources:

  • Prevalence of histoplasmosis in Nigerian children with presumptive tuberculosis: a multicentre study comparing two diagnostic techniques. Journal of Tropical Pediatrics, 2025;71(5).
  • Oxford Univ Press. (2025). Journal of Tropical Pediatrics. Great Clarendon St, Oxford OX2 6DP, England.
  • NewsRx. (2025). Report Summarizes Histoplasmosis Study Findings from Bassey E. Ekeng and Co-Researchers. TB & Outbreaks Week, October 21, 2025, p 409.