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J Int Assoc Provid AIDS Care. 2015 Sep-Oct;14(5):387-90. doi: 10.1177/2325957415592475. Epub 2015 Jul 2.

Feasibility and Acceptability of Cryptococcal Antigen Screening and Prevalence of Cryptocococcemia in Patients Attending a Resource-Limited HIV/AIDS Clinic in Malawi.

Author information

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.

KEYWORDS:

HIV/AIDS; asymptomatic cryptococcemia; cryptococcal meningitis; sub-Saharan Africa

PMID:
26139095
DOI:
10.1177/2325957415592475
[Indexed for MEDLINE]

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