Diagnostic capacity for cutaneous fungal diseases in the African continent.

BACKGROUND: Cutaneous fungal infections are very common, especially in poorer communities and with intercurrent HIV infection. Determining the fungal pathogen in skin-related fungal neglected tropical diseases (NTDs) determines optimal therapy. We undertook a country survey across many African countries to determine the diagnostic capacity for skin fungal diseases. METHODS: A detailed questionnaire was delivered to country contacts to collect data on availability, frequency, and location of testing for key diagnostic procedures and followed up with 2 rounds of validation by video call and by confirmation of individual country data confirmation by email. RESULTS: Of 47 countries with data, seven (15%) and 21 (45%) do not offer skin biopsy in the public or private sector, respectively, but 22 (46%) countries do it regularly, mostly in university hospitals. Direct microscopy is often performed in 20 of 48 (42%) countries in the public sector and not done in 10 (21%). Fungal cultures are often performed in 21 of 48 (44%) countries in the public sector but not done in nine (20%) or 21 (44%) in either public or private facilities. Histopathological examination of tissue is frequently used in 19 of 48 (40%) countries but not in nine (20%) countries in the public sector. The cost of diagnostics to patients was a major limiting factor in usage. CONCLUSION: Major improvements in the availability and use of diagnostic tests for skin, hair, and nail fungal disease are urgently needed across Africa.

The aetiology of acute community acquired bacterial meningitis in children and adults in Maputo, Mozambique.

BACKGROUND: Community-acquired acute bacterial meningitis is a life-threatening infection and many outbreaks have been reported all around the world. METHODOLOGY: We analysed 330 cerebrospinal fluid (CSF) samples received over a period of eight months from patients older than one month. Microscopy, cultures, identification, and antigen detection were performed for the positive samples. RESULTS: Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae type b were isolated in 5.4%, 4.8%, and 3.6% of CSF samples respectively. CONCLUSIONS: Our findings indicate that N. meningitidis is the most common cause of acute bacterial meningitis in Mozambique and that H. influenzae type b was isolated only from children aged younger than six years. This is the first study to provide data on the aetiological agents of acute bacterial meningitis in children and adults in Mozambique.