Cryptoccocal meningitis in Yaoundé (Cameroon) HIV infected patients: Diagnosis, frequency and Cryptococcus neoformans isolates susceptibility study to fluconazole

Ngouana, Thierry Kammalac; Dongtsa, J.; Kouanfack, Charles; Tonfack, Clément Auguste Djouatsa; Fomena, S.; Mallié, M.; Delaporte, Eric; Boyom, Fabrice Fekam; Bertout, Sébastien

doi:10.1016/j.mycmed.2014.10.016

Cited by 23 publications

(17 citation statements)

References 26 publications

(24 reference statements)

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“…However, in this study males, residing in rural areas, CD4 < 100 cells/mm 3 , and being hospitalized were statistically associated with cryptococcal antigenemia. Although cryptococcal infections occur in both sexes, a statistically significant difference in gender was also observed in other studies; this is likely due to poor health-seeking behavior of men to present later to care (Alemu et al, 2013;Assogoba et al, 2015;Ngouana et al, 2015) and the interaction Cryptococcus with testosterone, which results in increased capsular polysaccharide release and Cryptococcus-mediated macrophage death (McClelland et al, 2013). In addition to this, rural residents were at risk for cryptococcal infection.…”

Section: Discussionmentioning

confidence: 61%

“…This is similar to other studies in Sub-Saharan Africa. For example, in South Africa, CM was found 4/10 antigenemia-positive cases (Longley et al, 2016), in Cameroon 41/146 of patients who had clinical signs of meningitis (Ngouana et al, 2015), and in Tanzania 15/17 cryptococcal antigenemia-positive hospitalized patients (Wajanga et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

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Cryptococcal antigenemia and associated risk factors among ART‐naïve and ART‐experienced HIV‐infected peoples at selected health institutions of Mekelle, Northern Ethiopia

et al. 2018

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Cryptococcal infection is a major cause of opportunistic infection in HIV/AID‐infected peoples. We determined cryptococcal antigenemia and cryptococcal meningitis among antiretroviral therapy (ART) initiated and ART‐naive HIV‐infected peoples. A cross‐sectional study was conducted at selected health facilities in Mekelle, Ethiopia. Blood was collected to determine CD4 and plasma cryptococcal antigen (CrAg). CSF CrAg and CSF culture and urease tests were also done. Socio‐demographic and clinical data were collected using a structured questionnaire and clinical chart review. From the enrolled study participants, 267 study participants had complete data, of which, 137 (51%) were females. From the study participants, 140 (52%) and 127 (48%) were ART experienced and ART naïve, respectively. The prevalence of cryptococcal antigenemia was 9 (3.4%). All the study participants, except one (CD4 = 120 cells/mm 3 ), had CD4 count less than 100 cells/mm 3 . From CrAg‐positive peoples, 6 (4.7%) were ART naïve. Five CrAg‐positive peoples had cryptococcal meningitis. Being male, rural residence, and being hospitalized were associated with cryptococcal antigenemia. Cryptococcal infection poses a substantial risk of HIV‐positive peoples. This study provides relevant data for CrAg screening interventions in patients with low CD4 cell counts.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Cryptococcal antigenemia and associated risk factors among ART‐naïve and ART‐experienced HIV‐infected peoples at selected health institutions of Mekelle, Northern Ethiopia

et al. 2018

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“…The extract was concentrated under vacuum to afford a dark residue (250 g). Minimal inhibitory concentration (MIC) of the extract was determined according to the CLSI M27-A3 [ 6 ] protocol with little modifications. The RPMI 1640 supplemented with 2% glucose was used as culture medium.…”

Section: Methodsmentioning

confidence: 99%

“…Recent epidemiological data highlight the increasing burden of pathogenic yeasts on people in poor settings [ 2 , 3 , 4 ]. Candida species and Cryptococcus neoformans are the major pathogenic yeasts and only a few antifungal drugs have been developed so far to treat the invasive infections they cause [ 5 , 6 ]. Medicinal plants have shown credibility as sources of treatment for infectious diseases [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Compounds from Terminalia mantaly L. (Combretaceae) Stem Bark Exhibit Potent Inhibition against Some Pathogenic Yeasts and Enzymes of Metabolic Significance

et al. 2017

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Background: Pathogenic yeasts resistance to current drugs emphasizes the need for new, safe, and cost-effective drugs. Also, new inhibitors are needed to control the effects of enzymes that are implicated in metabolic dysfunctions such as cancer, obesity, and epilepsy. Methods: The anti-yeast extract from Terminalia mantaly (Combretaceae) was fractionated and the structures of the isolated compounds established by means of spectroscopic analysis and comparison with literature data. Activity was assessed against Candida albicans, C. parapsilosis and C. krusei using the microdilution method, and against four enzymes of metabolic significance: glucose-6-phosphate dehydrogenase, human erythrocyte carbonic anhydrase I and II, and glutathione S-transferase. Results: Seven compounds, 3,3′-di-O-methylellagic acid 4′-O-α-rhamnopyranoside; 3-O-methylellagic acid; arjungenin or 2,3,19,23-tetrahydroxyolean-12-en-28-oïc acid; arjunglucoside or 2,3,19,23-tetrahydroxyolean-12-en-28-oïc acid glucopyranoside; 2α,3α,24-trihydroxyolean-11,13(18)-dien-28-oïc acid; stigmasterol; and stigmasterol 3-O-β-d-glucopyranoside were isolated from the extract. Among those, 3,3′-di-O-methylellagic acid 4′-O-α-rhamnopyranoside, 3-O-methylellagic acid, and arjunglucoside showed anti-yeast activity comparable to that of reference fluconazole with minimal inhibitory concentrations (MIC) below 32 µg/mL. Besides, Arjunglucoside potently inhibited the tested enzymes with 50% inhibitory concentrations (IC50) below 4 µM and inhibitory constant (Ki) <3 µM. Conclusions: The results achieved indicate that further SAR studies will likely identify potent hit derivatives that should subsequently enter the drug development pipeline.

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“…Limited studies and some unpublished studies record frequencies of mild superficial mycosis [ 2 , 3 , 4 , 5 ] or life-threatening invasive fungal infections in the HIV-infected population in Cameroon [ 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. Ignorance of serious fungal infections, lack of awareness or involvement of practicing clinicians and the government, together with limited technical and structural health capabilities in Cameroon, have meant there is no register for any fungal disease.…”

Section: Introductionmentioning

confidence: 99%

The Burden of Serious Fungal Infections in Cameroon

Mandengue

Denning

2018

JoF

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Fungal infections are frequent in Cameroon, and invasive fungal infections are sometimes detected, usually in HIV-infected patients. For these reasons, we have estimated the burden of fungal infections. Using published literature and population estimates for the at-risk group, we used deterministic modelling to derive national incidence and prevalence estimates for the most serious fungal diseases. HIV infection is common and an estimated 120,000 have CD4 counts <200 × 106/mL and commonly present with opportunistic infection. Oesophageal candidiasis in HIV is common, and in poorly controlled diabetics. We estimate 6720 cases of cryptococcal meningitis, 9000 of Pneumocystis pneumonia, 1800 of disseminated histoplasmosis annually complicating AIDS, and 1200 deaths from invasive aspergillosis in AIDS, but there are no data. We found that 2.4% of adults have chronic obstructive pulmonary disease (COPD) and 2.65% have asthma, with “fungal asthma” affecting 20,000. Chronic pulmonary aspergillosis probably affects about 5000 people, predominantly after tuberculosis but also with COPD and other lung diseases. Also, tinea capitis in schoolchildren is frequent. Overall, an estimated 1,236,332 people are affected by a serious fungal infection. There is an urgent need for government and clinician attention, improved laboratory facilities, fungal diagnostic tests, and competent laboratory technicians, as well as all World Health Organization (WHO)-endorsed essential antifungal drugs to be made available, as only fluconazole is registered and available in the country.

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Cryptoccocal meningitis in Yaoundé (Cameroon) HIV infected patients: Diagnosis, frequency and Cryptococcus neoformans isolates susceptibility study to fluconazole

Cited by 23 publications

References 26 publications

Cryptococcal antigenemia and associated risk factors among ART‐naïve and ART‐experienced HIV‐infected peoples at selected health institutions of Mekelle, Northern Ethiopia

Cryptococcal antigenemia and associated risk factors among ART‐naïve and ART‐experienced HIV‐infected peoples at selected health institutions of Mekelle, Northern Ethiopia

Compounds from Terminalia mantaly L. (Combretaceae) Stem Bark Exhibit Potent Inhibition against Some Pathogenic Yeasts and Enzymes of Metabolic Significance

The Burden of Serious Fungal Infections in Cameroon

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