Chifundo Chipungu1, Jennifer A Veltman2, Perry Jansen1, Peter Chiliko1, Christina Lossa1, Dan Namarika1, Blake Benner1, Risa M Hoffman3, Claire C Bristow3, Jeffrey D Klausner4. 1. Partners in Hope Medical Centre, Lilongwe, Malawi. 2. Division of Infectious Diseases, University of California Los Angeles, Los Angeles, USA jenniferanneveltman@gmail.com. 3. Fielding School of Public Health, University of California Los Angeles, Los Angeles, USA. 4. Division of Infectious Diseases, University of California Los Angeles, Los Angeles, USA Fielding School of Public Health, University of California Los Angeles, Los Angeles, USA.
Abstract
BACKGROUND: The World Health Organization (WHO) recommends screening patients living with AIDS to detect and treat early cryptococcal infection. METHODS: The authors evaluated a cryptococcal antigen (CrAg) screening and treatment program at an HIV/AIDS clinic in Malawi. Eligible patients were of age >18 years, had a CD4 count <100 cells/µL or WHO clinical HIV/AIDS stage III or IV. RESULTS: Of 552 patients who presented for care, 113 were eligible, and all (100%) agreed to CrAg screening. Of them, 2 (1.8%; 95% confidence interval [CI]: 0-4.2%) patients were CrAg positive. Among those with CD4 count <100 cells/µL or WHO stage IV, the CrAg prevalence was 3.5% (95% CI: 0-8.4%) and 5.0% (95% CI: 0-15%), respectively. CONCLUSION: A CrAg screening program was acceptable to new patients in a Malawian HIV/AIDS clinic. The CrAg prevalence for patients with CD4 count < 100 cells/µL and WHO stage IV was consistent with cost-effectiveness estimates. CrAg screening and treatment programs for patients living with AIDS should be expanded.
BACKGROUND: The World Health Organization (WHO) recommends screening patients living with AIDS to detect and treat early cryptococcal infection. METHODS: The authors evaluated a cryptococcal antigen (CrAg) screening and treatment program at an HIV/AIDS clinic in Malawi. Eligible patients were of age >18 years, had a CD4 count <100 cells/µL or WHO clinical HIV/AIDS stage III or IV. RESULTS: Of 552 patients who presented for care, 113 were eligible, and all (100%) agreed to CrAg screening. Of them, 2 (1.8%; 95% confidence interval [CI]: 0-4.2%) patients were CrAg positive. Among those with CD4 count <100 cells/µL or WHO stage IV, the CrAg prevalence was 3.5% (95% CI: 0-8.4%) and 5.0% (95% CI: 0-15%), respectively. CONCLUSION: A CrAg screening program was acceptable to new patients in a Malawian HIV/AIDS clinic. The CrAg prevalence for patients with CD4 count < 100 cells/µL and WHO stage IV was consistent with cost-effectiveness estimates. CrAg screening and treatment programs for patients living with AIDS should be expanded.
Authors: Abigail Link; Mark Okwir; Betty Nabongo; David Meya; Sarah Iribarren; Paul Bohjanen; Danuta Kasprzyk Journal: Ann Glob Health Date: 2022-03-18 Impact factor: 2.462
Authors: Nathan Ford; Zara Shubber; Joseph N Jarvis; Tom Chiller; Greg Greene; Chantal Migone; Marco Vitoria; Meg Doherty; Graeme Meintjes Journal: Clin Infect Dis Date: 2018-03-04 Impact factor: 9.079