Tackling Histoplasmosis; a neglected disease impacting on equine health and human livelihoods. (360G-Wellcome-206638_Z_17_Z)

Histoplasmosis is a neglected yet prevalent disease among working equids in sub-Saharan Africa where horses provide a critical source of income and draught power for transport and agriculture to millions of people. There is a lack of evidence for the mechanisms of transmission and persistence of histoplasmosis offering little rationale upon which to base disease control. This novel multidisciplinary study will combine epidemiological, ecological and community engagement approaches to investigate the dynamics of this endemic disease, and will be achieved through an international collaboration across the academic, veterinary and NGO sectors. Phase 1 comprises a prospective multi-centre cohort study, a nested case-control study, and a clinical case-series. Clinical and environmental samples will be collected along with epidemiological data to determine the contribution of environment and host factors to both susceptibility and response to the disease. Clinical samples will be analysed using serological and molecular biological techniques to determine the presence and state of infection and to characterise Histoplasma diversity. Single-cell genome sequencing will be used to define predominant and/or virulent strains. Phase 2 will involve consultation with the community and regional stakeholders to share research findings and develop and disseminate disease prevention advice facilitated by the NGO partners.