Invasive fungal diseases (IFDs) are of huge concern in resource-limited settings, particularly in Africa, due to the unavailability of diagnostic armamentarium for IFDs, thus making definitive diagnosis challenging. IFDs have non-specific systemic manifestations overlapping with more frequent illnesses, such as tuberculosis, HIV, and HIV-related opportunistic infections and malignancies. Consequently, IFDs are often undiagnosed or misdiagnosed. We critically reviewed the available literature on IFDs in Africa to provide a better understanding of their epidemiology, disease burden to guide future research and interventions. Cryptococcosis is the most encountered IFD in Africa, accounting for most of the HIV-related deaths in sub-Saharan Africa. Invasive aspergillosis, though somewhat underdiagnosed and/or misdiagnosed as tuberculosis, is increasingly being reported with a similar predilection towards people living with HIV. More cases of histoplasmosis are also being reported with recent epidemiological studies, particularly from Western Africa, showing high prevalence rates amongst presumptive tuberculosis patients and patients living with HIV. The burden of pneumocystis pneumonia has reduced significantly probably due to increased uptake of anti-retroviral therapy among people living with HIV both in Africa, and globally. Mucormycosis, talaromycosis, emergomycosis, blastomycosis, and coccidiomycosis have also been reported but with very few studies from the literature. The emergence of resistance to most of the available antifungal drugs in Africa is yet of huge concern as reported in other regions. IFDs in Africa is much more common than it appears and contributes significantly to morbidity and mortality. Huge investment is needed to drive awareness and fungi related research especially in diagnostics and antifungal therapy.

Gastrointestinal histoplasmosis (GIH) is infrequently described in people without underlying HIV infection. We aimed to compare the clinical presentation of GIH in people with and without HIV infection. We conducted a literature search of published cases of GIH from 2001–2021 and found 212 cases. Of these, 142 (67.0%) were male, and 124 (58.5%) had HIV infection. Most cases were from North America (n = 88, 41.5%) and South America (n = 79, 37.3%). Of the 212 cases, 123 (58.0%) were included in both clinical and pathological analyses. The remainder were excluded as details about clinical and pathological findings were not available. Of the 123 cases, 41 had HIV infection while 82 were without HIV infection. The diagnosis was predominantly by histopathology (n = 109, 88.6%). A significant proportion of people with HIV infection had abdominal pain as the most predominant symptom of GIH compared to those without HIV infection (65.9% versus 41.9%, p < 0.05). The colon was the most affected site with a slightly higher proportion in those with HIV infection compared with cases without HIV infection (46.3% versus 42.7%). The commonest pathologic findings were caecal and ileal ulcers. Caecal ulcers were significantly more frequent in cases with HIV infection compared to those without HIV (32.1% versus 7.1%, p < 0.05). Despite being more common in people with HIV infection, GIH also affects people without HIV infection with similar clinical presentations.

Background and Objectives: Helicobacter pylori is a widely prevalent infection considered a significant public health challenge. Nigeria has the highest worldwide H. pylori prevalence. It is a notable cause of gastric cancer; thus, prompt diagnosis and treatment are required for eradication. The study aimed to determine the spectrum of endoscopic findings in patients with H. pylori infection at the University of Calabar Teaching Hospital. Materials and Methods: This was a retrospective cross-sectional study over a 4-year period on dyspeptic patients who presented at the hospital. Diagnosis of H. pylori infection was made through non-invasive techniques and patients who tested positive for H. pylori and were further assessed with upper gastrointestinal endoscopy were included in the study. A descriptive analysis of the data obtained was carried out using SPSS version 20. Results: One hundred and twenty-nine patients tested positive for H. pylori infection (46%) out of the two hundred and eighty dyspeptic patients evaluated during the period under study. However, only fifty-two (52) out of 129 dyspeptic patients who tested positive for H. pylori had upper gastrointestinal endoscopy and thus met the inclusion criteria. Upper gastrointestinal endoscopy revealed predominantly gastritis 37 (71.15%). This was followed by esophagitis in two (7.7%), duodenal ulcer two (3.8%), gastric ulcer three (5.8%), gastro-duodenitis four (7.7%), and gastric malignancy in two (3.8%) patients. Conclusion: Our study revealed that gastritis was the predominant endoscopic finding in patients with H. pylori infection. This finding is particularly significant because of the risk of development of gastric cancer in these patients from recurrent episodes of gastritis following late diagnosis and inappropriate treatment.

Gastro-oesophageal reflux disease (GORD) presents with either oesophageal or extra-oesophageal symptoms, or both. The association between symptom subtypes and upper gastrointestinal endoscopy (UGIE) findings has been rarely studied in Nigeria. Our study aimed to determine the pattern of symptom subtypes and UGIE abnormalities, as well as their association in patients with GORD symptoms in Nigeria. A retrospective, cross-sectional study of UGIE findings in patients with GORD from two endoscopy suites in southwest Nigeria, conducted from January 2022 to December 2023. Symptoms were categorised as oesophageal-only (OO), extra-oesophageal only (EO), or oesophageal plus extra-oesophageal (O + E). Demographic and UGIE data were compared using ANOVA, Pearson’s chi-square, or Fisher’s exact tests using R software. Analyses were two-tailed, and statistical significance was set at p < 0.017. There were 411 patients, 180 (43.8%) of whom were male, with a mean age of 45.3 years. The most frequent symptoms were chest pain (131, 31.9%) and heartburn (97, 23.6%). Overall, 280 (68.1%) of them presented with EO, 99 (24.1%) with OO, and 32 (7.8%) with O + E symptoms. Patients with O + E were younger (mean age 37.7 years) than those with OO (44.6 years) or EO (46.4 years), p = 0.008. On UGIE, gastroduodenal erosions were seen in 250 (60.8%), GORD-associated oesophageal injury in 183 (44.5%), peptic ulcer in 43 (10.5%), candidal oesophagitis in 38 (9.3%), tumour in 6 (1.5%), and normal findings in 34 (8.3%). Only gastroduodenal erosions were associated with symptom subtype. Most patients with GORD presented with extra-oesophageal symptoms. While fewer than half had reflux-associated oesophageal injury, non-oesophageal lesions were present in the majority of patients, highlighting the importance of endoscopic evaluation in patients with GORD symptoms.