Cover Image

Prevalence of cryptococcal antigen (CrAg) among HIV-positive patients in Eswatini, 2014-2015

Background: Cryptococcal meningitis is a leading cause of death amongst people living with HIV. However, routine cryptococcal antigen (CrAg) screening was not in the national guidelines in Eswatini. Objectives: A cross-sectional study was conducted between August 2014 and March 2015 to examine CrAg...

Full description

Saved in:
Bibliographic Details
Main Authors: Samson M. Haumba (Author), Mitsuru Toda (Author), Rossana Jeffries (Author), Peter Ehrenkranz (Author), Munyaradzi Pasipamire (Author), Trong Ao (Author), Nomthandazo Lukhele (Author), Sikhathele Mazibuko (Author), Mandzisi Mkhontfo (Author), Rachel M. Smith (Author), Tom Chiller (Author)
Format: Book
Published: AOSIS, 2020-07-01T00:00:00Z.
Subjects:
article
Online Access:Connect to this object online.
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: Cryptococcal meningitis is a leading cause of death amongst people living with HIV. However, routine cryptococcal antigen (CrAg) screening was not in the national guidelines in Eswatini. Objectives: A cross-sectional study was conducted between August 2014 and March 2015 to examine CrAg prevalence at Mbabane Government Hospital in Eswatini. Methods: We collected urine and whole blood from antiretroviral-therapy-naïve patients with HIV and a cluster of differentiation 4 (CD4) counts 200 cells/mm3 for plasma and urine CrAg lateral flow assay (LFA) screening at the national HIV reference laboratory. Two CD4 cut-off points were used to estimate CrAg prevalence: CD4 100 and 200 cells/mm3. Sensitivity and specificity of urine CrAg LFA was compared to plasma CrAg LFA. Results: Plasma CrAg prevalence was 4% (8/182, 95% confidence interval [CI]: 2-8) amongst patients with CD4 counts of 200 cells/mm3, and 8% (8/102, 95% CI: 3-15) amongst patients with CD4 counts of 100 cells/mm3. Urine CrAg LFA had a sensitivity of 100% (95% CI: 59-100) and a specificity of 80% (95% CI: 72-86) compared with plasma CrAg LFA tests for patients with CD4 200 cells/mm3. Forty-three per cent of 99 patients with CD4 100 were at World Health Organization clinical stages I or II. Conclusion: The prevalence of CrAg in Eswatini was higher than the current global estimate of 6% amongst HIV-positive people with CD4 100 cell/mm3, indicating the importance of initiating a national screening programme. Mechanisms for CrAg testing, training, reporting, and drug and commodity supply issues are important considerations before national implementation.
Item Description:2225-2002
2225-2010
10.4102/ajlm.v9i1.933

Similar Items