Frequency of Pneumocystis jirovecii in sputum from HIV and TB patients in Namibia

Introduction: The opportunistic fungus Pneumocystis jirovecii causes Pneumocystis pneumonia (PcP), which is a life-threatening infection in HIV/AIDS patients. The seemingly low prevalence of P. jirovecii pneumonia in sub-Saharan Africa has been a matter of great debate because many HIV/AIDS patients...

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Main Authors: Vincent Nowaseb, Esegiel Gaeb, Marcin G Fraczek, Malcolm D Richardson, David W Denning
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2014-03-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/3864
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author Vincent Nowaseb
Esegiel Gaeb
Marcin G Fraczek
Malcolm D Richardson
David W Denning
author_facet Vincent Nowaseb
Esegiel Gaeb
Marcin G Fraczek
Malcolm D Richardson
David W Denning
author_sort Vincent Nowaseb
collection DOAJ
description Introduction: The opportunistic fungus Pneumocystis jirovecii causes Pneumocystis pneumonia (PcP), which is a life-threatening infection in HIV/AIDS patients. The seemingly low prevalence of P. jirovecii pneumonia in sub-Saharan Africa has been a matter of great debate because many HIV/AIDS patients reside in this region. The lack of suitable diagnostic practices in this resource limited-region has been added to the uncertainty of PcP prevalence. Only a few studies have evaluated the utility of easily obtainable samples such as expectorated sputum for diagnosis of PcP. Thus, the aim of the current study was to evaluate the effectiveness of expectorated sputum for the routine diagnosis of PcP in a resource-limited sub-Saharan African setting. Methodology: Randomly collected sputum samples were analysed by microscopy after Grocott’s methenamine silver (GMS) stain staining and by qPCR to determine the minimum frequency of detectable P. jirovecii. Results: A total of 475 samples were analysed. Twenty five (5.3%) samples were positive for P. jirovecii, i.e., 17 (3.6%) using both qPCR and GMS staining and eight (1.7%) using qPCR only. P. jirovecii was present in 8/150 (5.3%) HIV-positive and tuberculosis (TB) smear-negative patients, and in 12/227 (5.3%) TB smear-negative patients with an unknown HIV status. The minimum frequency of PcP was 3.6% in Namibian HIV and TB patients, while the actual frequency is likely to be 5.3%. Conclusion: This study demonstrated that expectorated sputum can be used routinely for the diagnosis of PcP by GMS, although qPCR is more sensitive, and it requires less time and skill.
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spelling doaj-art-4967c70282a446a7a169c6ee2283e7cd2025-08-20T02:14:19ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802014-03-0180310.3855/jidc.3864Frequency of Pneumocystis jirovecii in sputum from HIV and TB patients in NamibiaVincent Nowaseb0Esegiel Gaeb1Marcin G Fraczek2Malcolm D Richardson3David W Denning4Allergy Clinical Research Facility, Manchester, United KingdomNamibia Institute of Pathology, Windhoek, NamibiaAllergy Clinical Research Facility, Manchester, United KingdomAllergy Clinical Research Facility, Manchester, United KingdomAllergy Clinical Research Facility, Manchester, United KingdomIntroduction: The opportunistic fungus Pneumocystis jirovecii causes Pneumocystis pneumonia (PcP), which is a life-threatening infection in HIV/AIDS patients. The seemingly low prevalence of P. jirovecii pneumonia in sub-Saharan Africa has been a matter of great debate because many HIV/AIDS patients reside in this region. The lack of suitable diagnostic practices in this resource limited-region has been added to the uncertainty of PcP prevalence. Only a few studies have evaluated the utility of easily obtainable samples such as expectorated sputum for diagnosis of PcP. Thus, the aim of the current study was to evaluate the effectiveness of expectorated sputum for the routine diagnosis of PcP in a resource-limited sub-Saharan African setting. Methodology: Randomly collected sputum samples were analysed by microscopy after Grocott’s methenamine silver (GMS) stain staining and by qPCR to determine the minimum frequency of detectable P. jirovecii. Results: A total of 475 samples were analysed. Twenty five (5.3%) samples were positive for P. jirovecii, i.e., 17 (3.6%) using both qPCR and GMS staining and eight (1.7%) using qPCR only. P. jirovecii was present in 8/150 (5.3%) HIV-positive and tuberculosis (TB) smear-negative patients, and in 12/227 (5.3%) TB smear-negative patients with an unknown HIV status. The minimum frequency of PcP was 3.6% in Namibian HIV and TB patients, while the actual frequency is likely to be 5.3%. Conclusion: This study demonstrated that expectorated sputum can be used routinely for the diagnosis of PcP by GMS, although qPCR is more sensitive, and it requires less time and skill. https://jidc.org/index.php/journal/article/view/3864fungal diseasesHIVopportunistic infectionsPneumocystis jiroveciituberculosissputum
spellingShingle Vincent Nowaseb
Esegiel Gaeb
Marcin G Fraczek
Malcolm D Richardson
David W Denning
Frequency of Pneumocystis jirovecii in sputum from HIV and TB patients in Namibia
Journal of Infection in Developing Countries
fungal diseases
HIV
opportunistic infections
Pneumocystis jirovecii
tuberculosis
sputum
title Frequency of Pneumocystis jirovecii in sputum from HIV and TB patients in Namibia
title_full Frequency of Pneumocystis jirovecii in sputum from HIV and TB patients in Namibia
title_fullStr Frequency of Pneumocystis jirovecii in sputum from HIV and TB patients in Namibia
title_full_unstemmed Frequency of Pneumocystis jirovecii in sputum from HIV and TB patients in Namibia
title_short Frequency of Pneumocystis jirovecii in sputum from HIV and TB patients in Namibia
title_sort frequency of pneumocystis jirovecii in sputum from hiv and tb patients in namibia
topic fungal diseases
HIV
opportunistic infections
Pneumocystis jirovecii
tuberculosis
sputum
url https://jidc.org/index.php/journal/article/view/3864
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