{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T03:54:55Z","timestamp":1792641295620,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T00:00:00Z","timestamp":1621814400000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T00:00:00Z","timestamp":1621814400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006229","name":"Oak Ridge Institute for Science and Education","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006229","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Histoplasmosis and cryptococcosis are important public health problems in people living with HIV (PLHIV) in Central America. Conventional laboratory assays, based on microscopy and culture, are not optimal for the diagnosis of either disease. However, antigen (Ag) assays are rapid and highly accurate for the diagnosis of these infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Laboratory surveillance of PLHIV was carried out in four hospitals in Panama, Honduras and Nicaragua, between 2015 and 2019. Detection of <jats:italic>Histoplasma<\/jats:italic> antigens in urine was performed by enzyme immunoassay (EIA), and <jats:italic>Cryptococcus<\/jats:italic> antigen detection in sera and cerebrospinal fluid specimens was performed by lateral flow assay (LFA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 4,453 PLHIV with clinical suspicion of histoplasmosis (<jats:italic>n<\/jats:italic>\u00a0=\u00a01,343) or cryptococcosis (<jats:italic>n<\/jats:italic>\u00a0=\u00a03,110; 2,721 sera and 389 CSF) were tested. Of 1,343 patients suspected of having histoplasmosis, 269 (20%) were <jats:italic>Histoplasma<\/jats:italic> Ag positive. Of 3,110 patients tested using the <jats:italic>Cryptococcus<\/jats:italic> Ag assay, 329 (11%) were positive. Honduras reported the highest positivity rates (32% for <jats:italic>Histoplasma<\/jats:italic> Ag, and 16% for <jats:italic>Cryptococcus<\/jats:italic> Ag); Panama reported the largest number of patients testing positive using the <jats:italic>Histoplasma<\/jats:italic> Ag assay (<jats:italic>n<\/jats:italic>\u00a0=\u00a0201); and Nicaragua reported the largest number of patients testing positive using the <jats:italic>Cryptococcus<\/jats:italic> Ag assay (<jats:italic>n<\/jats:italic>\u00a0=\u00a0170).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Here, we show how the implementation of rapid diagnostics assays impacted case detection and was useful for the care of people with advanced HIV. Rapid and accurate diagnosis could reduce mortality associated with histoplasmosis and cryptococcosis in PLHIV.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13303","type":"journal-article","created":{"date-parts":[[2021,5,9]],"date-time":"2021-05-09T13:24:40Z","timestamp":1620566680000},"page":"1396-1401","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Implementation of rapid diagnostics assays for detection of histoplasmosis and cryptococcosis in central american people living with HIV"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8749-9809","authenticated-orcid":false,"given":"Diego H.","family":"Caceres","sequence":"first","affiliation":[{"name":"Centers for Disease Control and Prevention (CDC) Atlanta GA USA"},{"name":"Department of Medical Microbiology Radboud University Medical Center and Radboudumc\u2010CWZ Center of Expertise for Mycology Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5880-8908","authenticated-orcid":false,"given":"Ana B.","family":"Arauz","sequence":"additional","affiliation":[{"name":"Hospital Santo Tomas Panama City Panama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Flores","sequence":"additional","affiliation":[{"name":"Hospital Santo Tomas Panama City Panama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Santiago","sequence":"additional","affiliation":[{"name":"Hospital Santo Tomas Panama City Panama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Montoya","sequence":"additional","affiliation":[{"name":"Hospital Escuela Tegucigalpa Honduras"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Saenz","sequence":"additional","affiliation":[{"name":"Centro Nacional de Diagn\u00f3stico y Referencia Managua Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe A.","family":"Torres\u2010Meneses","sequence":"additional","affiliation":[{"name":"Centro Nacional de Diagn\u00f3stico y Referencia Managua Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hortencia","family":"Peralta","sequence":"additional","affiliation":[{"name":"Hospital Escuela Antonio Lenin Fonseca Managua Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio Cesar","family":"Zuniga\u2010Moya","sequence":"additional","affiliation":[{"name":"Hospital Mario Catarino Rivas San Pedro de Sula Honduras"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isis Zohar","family":"Lainez Arteaga","sequence":"additional","affiliation":[{"name":"Hospital Mario Catarino Rivas San Pedro de Sula Honduras"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Garcia","sequence":"additional","affiliation":[{"name":"LLC. HIV\u2010TB Co\u2010infection Surveillance Strategies for Program Planning in the Central American Region under PEPFAR Formerly with University Research Co. Guatemala City Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3422-7719","authenticated-orcid":false,"given":"Jose","family":"Abdo","sequence":"additional","affiliation":[{"name":"LLC. HIV\u2010TB Co\u2010infection Surveillance Strategies for Program Planning in the Central American Region under PEPFAR Formerly with University Research Co. Guatemala City Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8600-9860","authenticated-orcid":false,"given":"Paul E.","family":"Verweij","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Radboud University Medical Center and Radboudumc\u2010CWZ Center of Expertise for Mycology Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2251-8033","authenticated-orcid":false,"given":"Tom M.","family":"Chiller","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention (CDC) Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Forno","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention (CDC) Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,24]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"2949","volume-title":"and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition)","author":"Deepe GS","year":"2015"},{"key":"e_1_2_8_3_1","first-page":"2934","volume-title":"and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition)","author":"Perfect JR","year":"2015"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30243-8"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30354-2"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.13-0084"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof5030073"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz534"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof5030076"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02430-16"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01238-18"},{"key":"e_1_2_8_12_1","volume-title":"The GAP report","author":"UNAIDS"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.16-0009"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328322ffac"},{"issue":"1","key":"e_1_2_8_15_1","first-page":"2009","article-title":"Frequency of invasive fungal disease in adults: experience of a specialized laboratory in medell\u00edn, Colombia (2009\u20132015)","volume":"6","author":"Valencia Y","year":"2020","journal-title":"J Fungi (Basel)"},{"issue":"4","key":"e_1_2_8_16_1","first-page":"ofz073","article-title":"Histoplasmosis, an underdiagnosed disease affecting people living with HIV\/AIDS in Brazil: results of a multicenter prospective cohort study using both classical mycology tests and histoplasma urine antigen detection","volume":"6","author":"Falci DR","year":"2019","journal-title":"Open Forum Infectious Dis"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001669"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix613"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.15-0108"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12902"},{"key":"e_1_2_8_21_1","volume-title":"Guidelines for Diagnosing and Managing Disseminated Histoplasmosis among People Living with HIV 2020","author":"PAHO\/WHO"},{"key":"e_1_2_8_22_1","volume-title":"Guidelines for the Diagnosis, Prevention and Management of Cryptococcal Disease in HIV\u2010Infected Adults, Adolescents and Children. 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