Intestinal parasitic infections (IPIs), caused by helminths and/or protozoa, continue to be a significant public health concern in Indonesia. Water access, sanitation, and hygiene practices (WASH) are influential factors for IPIs, especially among children. The aim of this study was to investigate the association between WASH and IPIs among school-aged children. A cross-sectional study involving 338 school-age children in an urban slum area in North Jakarta, Indonesia, was conducted using stool specimens subjected to microscopic and real-time polymerase chain reaction (rt-PCR) examination. The children underwent a finger-prick blood test and anthropometric measurements to determine anemia and nutritional status. Parents whose children participated in stool and blood examinations were interviewed using a modified WASH questionnaire. Helminth infections were not found in this study, whereas the overall prevalence of intestinal protozoa parasitic infection (IPPI) was 18.3% and 52.4% by microscopy and rt-PCR, respectively. Blastocystis spp. was found to have the highest prevalence (microscopy: 12%; rt-PCR: 48.6%), followed by Giardia intestinalis (microscopy: 0.6%; rt-PCR: 6.7%), Cryptosporidium spp. (microscopy: 5.1%; rt-PCR: 1.6%), and Entamoeba histolytica/dispar (microscopy: 0.6%; rt-PCR: 3.2%). Additionally, Dientamoeba fragilis was detected by rt-PCR at 4.1%. Furthermore, the discrepancies between microscopy and rt-PCR were observed in 8.9% (n=28) of the examined specimens. The majority of the respondents had a low-risk category of WASH profile. School children aged 5–10 years old (OR=2.06; 95%CI=1.27–3.33) and those who drank unprocessed cooking water (OR=1.95; 95%CI=1.07–3.57) were significantly associated with IPPI. The present study demonstrated that rt-PCR provides a better understanding of IPI epidemiology and has potential as a monitoring strategy for managing IPIs. Even though this population exhibits an adequate WASH profile and is not directly associated with IPIs, conducting a more in-depth observation of WASH facilities and practices is recommended to ensure a comprehensive assessment of the WASH profile. Additionally, engaging stakeholders in health promotion programs to ensure the sustainability of a good WASH profile and awareness of parasitic infections will be advantageous in achieving optimal urban health.

We performed morphology, molecular study and antifungal susceptibility test on 10 Talaromyces sp. isolates: eight clinical isolates (human immunodeficiency virus (HIV) and non-HIV-patient) and two isolates from rats. All strains produced red soluble pigment and microscopically showed Penicillium-like structure in room temperature and yeast-like structure in 37°C. Based on molecular analysis, nine isolates were identified as Talaromyces atroroseus (including the isolates from rats) and one as T. marneffei. Our susceptibility result of T. marneffei supports the use of amphotericin B, itraconazole for talaromycosis marneffei management. Talaromyces atroroseus showed variable MIC to echinocandin, azole derivatives, 5-flucytosine and amphotericin B.

Pulmonary histoplasmosis is often misdiagnosed as or coinfected with pulmonary tuberculosis (TB). This study aims to analyze the misdiagnosis or co-occurrence of published cases of pulmonary TB and pulmonary histoplasmosis. Cases of histoplasmosis with dissemination were excluded, as it affects other organs. Systematic research was conducted using PubMed, EBSCOhost, ProQuest, BioRxiv, and MedRxiv databases. Twenty-seven articles were included, covering a total of 51 cases. Males were predominantly affected, with a median age of 54 years. Exposure to caves and farming occupations were identified as the primary sources of infection (61.9%). The most common clinical symptoms were fever (80%) and cough (82.5%). Laboratory tests revealed culture positivity in 77.1% of cases, with sputum being the most frequently used specimens. In proven pulmonary histoplasmosis, antibody tests were positive in 18 out of 24 cases. Chest X-rays commonly showed cavities, infiltrates, and nodules, with an increase in nodular pattern in recent cases. The number of pulmonary nodules detected was higher on chest computed tomography (CT). Radiologic abnormality could occur in any lung region. This review suggests the potential for misdiagnosis and/or coinfection of pulmonary histoplasmosis and pulmonary TB. The combination of clinical suspicion, radiological findings, antibody and/or antigen testing could improve the diagnosis of pulmonary histoplasmosis.

This review summarises the current knowledge of the interactions between Histoplasma capsulatum (Hc) and the human immune system, with particular emphasis on host immune responses and fungal immune evasion mechanisms that modulate disease pathogenesis and clinical outcomes. Histoplasmosis is a disease caused by Hc, a fungus found worldwide. Upon inhala- tion, complex interactions occur between the pathogen and the human immune system, primarily involving the recognition of fungal cell wall components. Both innate and adaptive immune responses are orchestrated to eliminate the fungus through a tightly regulated balance. However, Hc has evolved multiple strategies to evade host defences and establish infection. The clinical spectrum of histoplasmosis varies, ranging from isolated pulmonary involvement to disseminated disease, depending on host factors and pathogen characteristics. Conclusion. Overall, host-pathogen interactions between Hc and the human immune system play a central role in determining disease outcomes and represent key targets for improving preventive, diagnostic, and treatment strategies.