(CARICOM Secretariat, Turkeyen, Greater Georgetown, Guyana) What is probably among the most common and most deadly AIDS defining infections in the Guianas, the Amazon and Central America remains largely overlooked. Disseminated Histoplasmosis often mimics tuberculosis which can lead to false “drug-resistant tuberculosis”.
The French Guiana AIDS Coordination system has been communicating for over a decade to alert the Caribbean (mainly through meetings of the Pan Caribbean Partnership for HIV/AIDS (PANCAP) that Histoplasmosis is a serious threat for People Living with HIV/AIDS (PLWH).
Histoplasmosis is a serious public health issue that is relatively unknown in the region. Many deaths could be avoided through early detection and treatment. However, diagnosis is difficult because medical mycology is one of the least developed areas of laboratory practice. A new test, a Histoplasma ELISA Antigen detection test, recently developed by the US-based Center for Disease Control, (CDC), has proven to be an important step towards improving diagnosis and reducing mortality.
A team from The French Guiana Health Council comprising General Director of the Health Regional Agency, Mr Philippe Damie and a team of researchers on this disease Prof Mathieu Nacher and Dr Antoine Adenis, visited Guyana in December 2011. They met with officials of PANCAP including, Director Mrs Juliette Bynoe-Sutherland, and the Guyana National AIDS Unit led by Dr Shanti Singh, to share information on a project which aims to evaluate the prevalence of disseminated histoplasmosis by measuring fungal antigens in serum and urine of HIV infected patients. They were also seeking to convince the National AIDS Programme, NAP and the management of the local President’s Emergency Plan for AIDS Relief, PEPFAR supported laboratory, to be part of a regional research project which includes French Guiana, the state of Amapa, Suriname and is intended to extend towards Trinidad and Tobago.
Monsieur Damie in describing the initiative stated that “we share the same HIV problem on the Guiana shield, and it is thus important for the Health Regional Agency to develop collaborations with neighbouring countries” “I have come to look at the way this project unfolds on the field, and have supported it and will continue to support it as best as we can”, “it shows what we can do when we put our forces together. Such projects allow us to know each other and can lead the way for further projects in other areas of health” “The Guianas working together on common health problems simply makes perfect sense”
The INSERM (French National Medical Research Institute) led research project will last for 36 months and the expected outcome will be increased awareness of the burden of histoplasmosis and the availability of an affordable, sensitive, rapid technique to diagnose one of the most likely causes of AIDS related death in South and Central America. CDC will transfer the technique to each country. In addition, the project builds the collaboration between partners of different countries with a common goal to work together on a project aimed at improving the care and treatment of persons living with HIV.
