{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:38:30Z","timestamp":1791898710467,"version":"4.3.4"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T00:00:00Z","timestamp":1695168000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health Indonesia"},{"name":"National Institute of Allergy and Infectious Diseases, National Institutes of Health","award":["HHSN261200800001E"],"award-info":[{"award-number":["HHSN261200800001E"]}]},{"name":"National Institute of Allergy and Infectious Diseases, National Institutes of Health","award":["HHSN261201500003I"],"award-info":[{"award-number":["HHSN261201500003I"]}]},{"name":"DIPI\/LPDP-Newton Fund","award":["MR\/P017622\/1"],"award-info":[{"award-number":["MR\/P017622\/1"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Histoplasma capsulatum<\/jats:italic>\n                      exposure is rarely suspected in Indonesia. Pulmonary histoplasmosis can occur simultaneously with pulmonary tuberculosis (TB) or as an alternative diagnosis in clinically-diagnosed TB patients with no microbiological evidence of TB. This study aimed to determine the seroprevalence of anti-\n                      <jats:italic>H<\/jats:italic>\n                      .\n                      <jats:italic>capsulatum<\/jats:italic>\n                      IgG antibody among pulmonary TB patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>\n                      This was a sub-study of 306 participants from a prospective cohort pulmonary TB study conducted at seven TB referral hospitals in Indonesia. The study population was presumptive pulmonary TB adult patients who underwent microbiological TB examinations and were categorized as drug-sensitive (DS), drug-resistant (DR), and clinically-diagnosed TB. Anti-\n                      <jats:italic>H<\/jats:italic>\n                      .\n                      <jats:italic>capsulatum<\/jats:italic>\n                      IgG antibody levels at baseline were measured using MVista Histoplasma Ab enzyme immunoassays. Data were summarized using descriptive statistics. Bivariate and multivariate logistic regression analysis were performed to assess factors associated with anti-\n                      <jats:italic>H<\/jats:italic>\n                      .\n                      <jats:italic>capsulatum<\/jats:italic>\n                      IgG antibody positive result.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      12.7% (39\/306) of pulmonary TB patients were positive for anti-\n                      <jats:italic>H<\/jats:italic>\n                      .\n                      <jats:italic>capsulatum<\/jats:italic>\n                      IgG antibodies (DR-TB patients (15.9%, 18\/114), DS-TB (13.0%, 15\/115), and clinically-diagnosed TB (7.8%, 6\/77)). The median unit value of anti-\n                      <jats:italic>H<\/jats:italic>\n                      .\n                      <jats:italic>capsulatum<\/jats:italic>\n                      IgG antibody for all positive samples was 15.7 (IQR 10.2\u201328.9) EU. This median unit value was higher in clinically-diagnosed TB patients compared to DS-TB or DR-TB patients (38.1 (IQR 25.6\u201346.6) EU, 19.7 (IQR 12.3\u201328.9) EU, and 10.9 (IQR 9.2\u201315.4), respectively). There were 10 patients (3.3%) with anti-\n                      <jats:italic>H<\/jats:italic>\n                      .\n                      <jats:italic>capsulatum<\/jats:italic>\n                      IgG antibody levels above 30 EU. Factors associated with the anti-\n                      <jats:italic>H<\/jats:italic>\n                      .\n                      <jats:italic>capsulatum<\/jats:italic>\n                      IgG antibody positive result were malignancies (OR 4.88, 95% CI 1.09\u201321.69, p = 0.037) and cavitary lesions (OR 2.27, 95% CI 1.09\u20134.70, p = 0.028).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Our results provide evidence of exposure to\n                      <jats:italic>H<\/jats:italic>\n                      .\n                      <jats:italic>capsulatum<\/jats:italic>\n                      among pulmonary TB patients in Indonesia. Further studies are needed to provide a comprehensive picture of this fungal disease in other populations and regions to enhance awareness among clinicians and public health officials.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0011575","type":"journal-article","created":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T13:24:56Z","timestamp":1695216296000},"page":"e0011575","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["The seroprevalence of anti-Histoplasma capsulatum IgG antibody among pulmonary tuberculosis patients in seven referral tuberculosis hospitals in Indonesia"],"prefix":"10.1371","volume":"17","author":[{"given":"Tutik","family":"Kusmiati","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erlina","family":"Burhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Retna Indah","family":"Sugiyono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dona","family":"Arlinda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4257-3113","authenticated-orcid":true,"given":"Adhella Menur","family":"Naysilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Banteng Hanang","family":"Wibisono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riat","family":"El Khair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ni Wayan","family":"Candrawati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bintang Yinke Magdalena","family":"Sinaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irawaty","family":"Djaharrudin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dewi","family":"Lokida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman","family":"Kosasih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nugroho Harry","family":"Susanto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deni Pepy","family":"Butar Butar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robiatul","family":"Adawiyah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayu Eka","family":"Fatril","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Karyana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Denning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3294-5792","authenticated-orcid":true,"given":"Retno","family":"Wahyuningsih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,9,20]]},"reference":[{"issue":"4","key":"pntd.0011575.ref001","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.wem.2018.06.008","article-title":"Environmental and Wilderness-Related Risk Factors for Histoplasmosis: More Than Bats in Caves","volume":"29","author":"JH Diaz","year":"2018","journal-title":"Wilderness Environ Med"},{"issue":"1","key":"pntd.0011575.ref002","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1128\/CMR.00027-06","article-title":"Histoplasmosis: a clinical and laboratory update","volume":"20","author":"CA Kauffman","year":"2007","journal-title":"Clin Microbiol Rev"},{"issue":"7","key":"pntd.0011575.ref003","doi-asserted-by":"crossref","first-page":"ofab306","DOI":"10.1093\/ofid\/ofab306","article-title":"Revising Conventional Wisdom About Histoplasmosis in the United States","volume":"8","author":"K Benedict","year":"2021","journal-title":"Open Forum Infect Dis"},{"issue":"2","key":"pntd.0011575.ref004","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1055\/s-2004-824898","article-title":"Pulmonary histoplasmosis syndromes: recognition, diagnosis, and management","volume":"25","author":"LJ Wheat","year":"2004","journal-title":"Semin Respir Crit Care Med"},{"key":"pntd.0011575.ref005","unstructured":"Chromoblastomycosis and other deep mycoses have been added to the NTD portfolio [Internet]. 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