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Mucorales fungi cause mucormycosis, an invasive and rapidly progressive disease which increasingly affects mostly immunocompromised but also immunocompetent individuals. The objective of this study was to highlight the epidemiology, diagnostic modalities, treatment and overall survival of mucormycosis in Africa. We searched for relevant publications in PubMed, Google Scholar and African Journal Online databases covering the period 1960–2022. A total of 147 articles were identified, of which 66 were included in the review, detailing 408 individual cases from 12 African countries; 330 (80.9%) from North Africa, 63 (15.4%) from Southern Africa, seven (1.7%) from East Africa, seven (1.7%) from West Africa and a single case (0.2%) from Central Africa. The most frequently described clinical forms were rhino‐orbital‐cerebral (n = 307, 75.2%) and gastrointestinal (n = 51, 12.5%). Diabetes mellitus, COVID‐19, malignancies and neutropaenia were the commonest underlying risks in 203 (49.8%), 101 (24.8%), 65 (15.9%) and 53 (13.0%) cases respectively. Most cases, 296 (72.5%) were diagnosed by histopathology. Fungal aetiology was identified in 38 (9.3%), of which the commonest was Rhizopus oryzae/arrhizus (27/38, 71.1%). Of the 408 cases, 334 (81.9%) patients received antifungal therapy, while 244 (59.8%) had surgery. In cases with a specified outcome, survival rate was 59.1% (228/386). Based on case reporting, a substantial burden of mucormycosis occurs in North Africa but the disease is rarely reported in most of the sub‐Saharan region. Establishing a comprehensive registry for standardised data collection could improve understanding of the epidemiology of mucormycosis in the region. [ABSTRACT FROM AUTHOR]

Background: Most of the study reviews on Histoplasma capsulatum var duboisii (Hcd) infection have been limited to case reports from few African countries despite having cases reported outside Africa. We aimed at providing an update on the global epidemiology of histoplasmosis caused by Hcd, its diagnostic challenges and recommendations for improved diagnosis. Materials and methods: We conducted a retrospective review of case reports and case series on Hcd infection published "between 1st January 1950 to 31st December 2021" using PubMed, Google Scholar and African Journals Online. The following search terms: "African histoplasmosis" and "Histoplasma duboisii" AND/OR "diagnosis of African histoplasmosis" were used. Publications on histoplasmosis caused by H. capsulatum var. capsulatum (Hcc) were excluded. Data extracted from each case included: age, gender, disease type (single organ vs. disseminated disease), sites of infection, clinical features, HIV status, diagnostic tests, treatment, and patient outcome. Results: We identified 415 cases of Hcd infection reported globally (1950 - 2021); 359 (86.5%) cases from Africa, while 56 (13.5%) were from other geographical regions. Hcd infection was misdiagnosed as other clinical entities including tuberculosis, malignancies, osteomyelitis, neurofibromatosis, and cystic lesions. Out of the 415 cases, diagnostic modality was specified in 307 (74%) cases, with histopathology (n=270, 87.9%) as the predominant diagnostic method followed by culture (n=59, 19.2%). Conclusion: Like classical histoplasmosis, the clinical presentation of Hcd infection mimics other diseases, hence a high index of suspicion by the attending clinician would be invaluable in making a prompt diagnosis and invariably improve clinical outcomes. In addition, there is a need to build capacity in molecular diagnostics and antigen assay specific for detecting Hcd infection as classical diagnostic methods have been proven to be inadequate. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]