Population-based surveillance for cryptococcosis in an antiretroviral-naive South African province with a high HIV seroprevalence

McCarthy, Kerrigan; Morgan, Juliette; Wannemuehler, Kathleen; Mirza, Sara; Gould, Susan Martin; Mhlongo, Ntombi; Moeng, Portia; Maloba, Bonnie R.; Crewe-Brown, H. H.; Brandt, Mary E.; Hajjeh, Rana

doi:10.1097/qad.0b013e3280106d6a

Cited by 103 publications

(79 citation statements)

References 27 publications

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“…In Houston, USA, the mean annual incidence reported for the year 2000 was of 0.4 cases per 100,000 inhabitants (28). In Africa, the incidence is even higher: 15.6/100,000 revealing the heavy disease burden due to cryptococcosis (29). In regions like the Northern Territory in Australia, it has been reported that the mean annual incidence per million population was 6.6 and in New Zealand, of 2.2 (30), similar to the incidence reported in Colombia.…”

Section: Discussionmentioning

confidence: 85%

Criptococosis en Colombia: resultados de la encuesta nacional, 2006-2010

et al. 2012

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Introduction: A survey on cryptococcosis is being conducted regularly in Colombia since 1997. We present hereby the results corresponding to patients diagnosed from 2006 to 2010. Objective: To analyze the data obtained during this period. Materials and methods:Retrospective analysis of the corresponding surveys. Results: A total of 526 surveys originating from 72% of the Colombian political divisions were received during the 5-year period. Most patients (76.6%) were males and 74.9% were 21-50 years old. The most prevalent risk factor was HIV infection (83.5%) with cryptococcosis defining AIDS in 23% of the cases. In the general population the estimated mean annual incidence rate for cryptococcosis was 2.4 x 10 6 inhabitants while in AIDS patients this rate rose to 3.3 x 10 3 . In 474 surveys stating clinical features, most frequent complaints were headache 84.5%, fever 63.4%, nausea and vomiting 57.5%, mental alterations 46.3%, meningeal signs 33.0%, cough 26.4% and visual alterations 24.5%. Neurocryptococcosis was recorded in 81.8% of the cases. Laboratory diagnosis was based on direct examination, culture and latex in 29.3% cases. From 413 Cryptococcus isolates analyzed, 95.6% were identified as C. neoformans var. grubii, 1% C. neoformans var. neoformans, and 3.4% C. gattii. Treatment was reported for 71.6% of the cases with amphotericin B alone or in combination with fluconazole prescribed in 28%. Conclusions: Surveys done through passive surveillance continue to be sentinel markers for HIV infection and represent a systematic approach to the study of opportunistic problems regularly afflicting AIDS patients since cryptococcosis requires no compulsory notification in Colombia. Author contributions:Patricia Escandón: played an important role in writing and preparing the manuscript, in charge of the surveillance at the Instituto Nacional de Salud, controlled receipt of questionnaires. Catalina de Bedout: in charge of the mycological diagnosis for all Corporación para Investigaciones Biológicas cases, established links with physicians in charge of patients, controlled receipt of questionnaires and performed the susceptibility testing in all isolates. Jairo Lizarazo: physician in charge of the patients from Norte de Santander, checked the questionnaire's contents for medical accuracy, analyzed the data through statistical analysis. Clara Inés Agudelo: worked all long in the surveillance study, played an important role in preparation of the manuscript and in the analysis of the data, including statistical tests. Ángela Tobón: examined many of the Corporación para Investigaciones Biológicas patients, filled in the corresponding questionnaires, supervised the clinical aspects of most patients and served as a consultant for other physicians in charge of cryptococcosis patients. Solmara Bello: in charge of the mycological diagnosis for Instituto Nacional de Salud cases. Ángela Restrepo: surveillance of the whole program, contacting physicians and serving as consultant for all participants, analyzing data, writing of ...

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Section: Discussionmentioning

confidence: 85%

Criptococosis en Colombia: resultados de la encuesta nacional, 2006-2010

et al. 2012

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“…En E.U.A. la incidencia de la enfermedad en niños con SIDA, parece ser de alrededor de 0,5 a 1% 17,22 , aunque se han reportado cifras mayores en Sudáfrica y Tailandia 23 .…”

Section: Discussionunclassified

Meningitis por Cryptococcus neoformans en niños y adolescentes infectados por virus de la inmunodeficiencia humana

Quian

Gutiérrez

González

et al. 2012

Rev. chil. infectol.

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“…The India ink test has good sensitivity (80 -98%) 7,21 and specificity in ARV-naïve and fluconazole-naïve populations, but may have lower sensitivity in patients who are receiving fluconazole for other reasons (commonly mucocutaneous candidiasis), who present early in the course of disease and who have low fungal burden in the CSF. A negative India ink test does not exclude the diagnosis.…”

Section: Laboratory Diagnostic Tests For CCmentioning

confidence: 99%

Guidelines for the prevention, diagnosis and management of cryptococcal meningitis and disseminated cryptococcosis in HIV-infected patients

McCarthy

Meintjes

Arthington-Skaggs

et al. 2007

South. Afr. j. HIV med.

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Population-based surveillance for cryptococcosis in an antiretroviral-naive South African province with a high HIV seroprevalence

Abstract: This study demonstrates the high disease burden due to cryptococcosis in an antiretroviral-naive South African population and emphasizes the need to improve early recognition, diagnosis and treatment of the condition.

Cited by 103 publications

References 27 publications

Criptococosis en Colombia: resultados de la encuesta nacional, 2006-2010

Criptococosis en Colombia: resultados de la encuesta nacional, 2006-2010

Meningitis por Cryptococcus neoformans en niños y adolescentes infectados por virus de la inmunodeficiencia humana

Guidelines for the prevention, diagnosis and management of cryptococcal meningitis and disseminated cryptococcosis in HIV-infected patients

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