Prevalence and Hospital Management of Amphotericin B Deoxycholate-Related Toxicities during Treatment of HIV-Associated Cryptococcal Meningitis in South Africa

Meiring, Susan; Smidt, Melony C Fortuin-de; Kularatne, Ranmini; Dawood, Halima; Govender, Nelesh P.; Germs-Sa,

doi:10.1371/journal.pntd.0004865

Cited by 29 publications

(38 citation statements)

References 23 publications

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“…More importantly, the FFP choice of food vehicles (i.e., staple foods such as maize meal and flour) is possibly reaching many South Africans, even in the remote rural areas. Prior studies have associated the Hb levels of Africans with a multitude of factors, such as food and nutrition insecurity, suboptimal diets as a result of poverty due to socioeconomic deprivation, and infection due to chronic and/or infectious diseases . It was therefore important to investigate the changes in the prevalence of anemia, ID, and IDA over the past 10 years.…”

Section: Discussionmentioning

confidence: 99%

“…Iron stores/red blood cells can also be diminished during menstruation, during bouts of infections, and as a result of chronic non‐communicable diseases (NCDs) . Hence, the research done in Africa has shown that this condition is more prevalent/common among women of reproductive age, people who have limited access to basic needs (such as sanitation and treated water), and people exposed to infectious diseases and those at risk of NCDs …”

Section: Introductionmentioning

confidence: 99%

“…Recent localized studies in SA also increased awareness of other important factors that fuel anemia in the country . These factors include inflammation due to infectious diseases (tuberculosis (TB) and HIV/AIDS), chronic diseases (especially chronic kidney failure), and selected drug therapies .…”

Section: Introductionmentioning

confidence: 99%

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Understanding the determinants of hemoglobin and iron status: adolescent–adult women comparisons in SANHANES‐1

Mchiza

Parker

Sewpaul

et al. 2018

Annals of the New York Academy of Sciences

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The study compared hemoglobin (Hb) and serum ferritin levels between adolescent and adult women with different body mass indices, dietary intake, and sociodemography. A secondary analysis of data for 3177 South African women ⩾15 years of age who participated in the SANHANES-1 study was undertaken. Abnormal Hb (≤12 g/dL) and serum ferritin (<15 μg/mL) were based on the World Health Organization's criteria for nonpregnant women aged ⩾15 years. Data were analyzed using STATA version 11. Overall, anemia was detected in 740 (23.3%) participants. Of the individuals in the subsample (n = 1123, 15-35 years) who had serum ferritin measured, 6.0% presented with iron depletion (ID) and 10.8% presented with iron-deficiency anemia (IDA). The highest prevalences of anemia, ID, and IDA were in 15- to 18-year-olds (11.2%, 8.8%, and 20.2%, respectively). Black young adults (19-24 years) were up to 40 times more likely to present with ID compared with their non-black counterparts. While overweight adolescents were three times more likely to be anemic, overweight and obese young adults, as well as obese older adults (25-35 years), were less likely to be anemic compared with normal-weight women of all age groups. Overconsumption of dietary fat increased ID by up to 54- and 11-fold (adolescents and 25- to 35-year-olds, respectively). In South Africa, anemia is most prevalent in adolescents and black women. Anemia is also an indicator of overconsumption of dietary fat and a marker of socioeconomic disadvantage.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Understanding the determinants of hemoglobin and iron status: adolescent–adult women comparisons in SANHANES‐1

Mchiza

Parker

Sewpaul

et al. 2018

Annals of the New York Academy of Sciences

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“…In the current study, SYBR Green and TaqMan were 100% specific. High specificity is the most important characteristic of any ATL diagnostic test, as the unjustified prescription of pentavalent antimonials or amphotericin B for patients without ATL can be extremely harmful (19,20).…”

Section: Discussionmentioning

confidence: 99%

Field Validation of SYBR Green- and TaqMan-Based Real-Time PCR Using Biopsy and Swab Samples To Diagnose American Tegumentary Leishmaniasis in an Area Where Leishmania (Viannia) braziliensis Is Endemic

et al. 2017

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The precise diagnosis of American tegumentary leishmaniasis (ATL) is an essential task due to the disease's associated morbidity. A noninvasive, extremely sensitive, and highly specific exam is critical, particularly for mucosal leishmaniasis (ML), in which a low parasite quantity is expected. We aimed to compare the diagnostic accuracy of swab and biopsy sample analysis using SYBR Green-and TaqManbased real-time PCR (qPCR) assays with that of a composite reference standard consisting of the Montenegro skin test, serology, histopathology, smears, culture, and conventional PCR. In total, 55 patients with ATL (ML, 18 patients; cutaneous leishmaniasis [CL], 37 patients) and 36 patients without ATL were studied. qPCR analysis of swabs was more accurate when using SYBR Green (87.88%; 95% confidence interval [CI], 77.86 to 93.73 patients) than when using TaqMan (78.79%; 95% CI, 67.49 to 86.92%) (P ϭ 0.031). SYBR Green (84.72%; 95% CI, 74.68 to 91.25%) was also more accurate than TaqMan (73.61%; 95% CI, 62.42 to 82.41%) for biopsy samples (P ϭ 0.008). All qPCR methods were 100% specific. Swabs and biopsy specimens had similar sensitivity when using the same chemistry (P ϭ 0.125 for SYBR Green and P ϭ 0.625 for TaqMan). Moreover, qPCR achieved better performance than most existing techniques used for the diagnosis of ATL and also detected the Leishmania parasite in a greater proportion of patients than the associated histopathology, smear, culture, and conventional PCR techniques did. Swabs therefore represent a useful diagnostic tool because they not only are noninvasive but also can achieve an accuracy similar to that of biopsy samples. The high accuracy of SYBR Green-based qPCR may also reduce the requirement for associated parasitological tests for ATL diagnosis.

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“…In 10% (4/41) of included studies, the period of observation began prior to 2000. Seventeen countries were represented, with greatest representation from South Africa (14 studies) [34,[37][38][39][40][41][42][43][44][45][46][47][48][49], Ethiopia (three studies) [50][51][52] and Uganda (three studies) [53][54][55]; other countries had two or fewer studies [11,35,36,[56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74]. Amphotericin B-based induction therapy (with or without fluconazole) was the predominant induction regimen in 16 studies, fluconazole in 13 studies, and a mix of treatments (45% fluconazole and 43% amphotericin B) in one study [44], with antifungal regimens not specified in 11 studies.…”

Section: Overall Search Findingsmentioning

confidence: 99%

Mortality from HIV‐associated meningitis in sub‐Saharan Africa: a systematic review and meta‐analysis

et al. 2020

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Introduction HIV‐associated cryptococcal, TB and pneumococcal meningitis are the leading causes of adult meningitis in sub‐Saharan Africa (SSA). We performed a systematic review and meta‐analysis with the primary aim of estimating mortality from major causes of adult meningitis in routine care settings, and to contrast this with outcomes from clinical trial settings. Methods We searched PubMed, EMBASE and the Cochrane Library for published clinical trials (defined as randomized‐controlled trials (RCTs) or investigator‐managed prospective cohorts) and observational studies that evaluated outcomes of adult meningitis in SSA from 1 January 1990 through 15 September 2019. We performed random effects modelling to estimate pooled mortality, both in clinical trial and routine care settings. Outcomes were stratified as short‐term (in‐hospital or two weeks), medium‐term (up to 10 weeks) and long‐term (up to six months). Results and discussion Seventy‐nine studies met inclusion criteria. In routine care settings, pooled short‐term mortality from cryptococcal meningitis was 44% (95% confidence interval (95% CI):39% to 49%, 40 studies), which did not differ between amphotericin (either alone or with fluconazole) and fluconazole‐based induction regimens, and was twofold higher than pooled mortality in clinical trials using amphotericin based treatment (21% (95% CI:17% to 25%), 17 studies). Pooled short‐term mortality of TB meningitis was 46% (95% CI: 33% to 59%, 11 studies, all routine care). For pneumococcal meningitis, pooled short‐term mortality was 54% in routine care settings (95% CI:44% to 64%, nine studies), with similar mortality reported in two included randomized‐controlled trials. Few studies evaluated long‐term outcomes. Conclusions Mortality rates from HIV‐associated meningitis in SSA are very high under routine care conditions. Better strategies are needed to reduce mortality from HIV‐associated meningitis in the region.

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Prevalence and Hospital Management of Amphotericin B Deoxycholate-Related Toxicities during Treatment of HIV-Associated Cryptococcal Meningitis in South Africa

Cited by 29 publications

References 23 publications

Understanding the determinants of hemoglobin and iron status: adolescent–adult women comparisons in SANHANES‐1

Understanding the determinants of hemoglobin and iron status: adolescent–adult women comparisons in SANHANES‐1

Field Validation of SYBR Green- and TaqMan-Based Real-Time PCR Using Biopsy and Swab Samples To Diagnose American Tegumentary Leishmaniasis in an Area Where Leishmania (Viannia) braziliensis Is Endemic

Mortality from HIV‐associated meningitis in sub‐Saharan Africa: a systematic review and meta‐analysis

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