Tuberculosis/cryptococcosis co-infection in China between 1965 and 2016

Abstract

Cases of tuberculosis/cryptococcosis co-infection are rapidly increasing in China. However, most studies addressing this co-infection have been published in Chinese journals, and this publication strategy has obscured this disease trend for scientists in other parts of the world. Our investigation found that 62.9% of all co-infection cases worldwide were reported in the Chinese population (n=197) between 1965 and 2016, and 56.3% of these Chinese cases were reported after 2010. Nearly all cases originated from the warm and wet monsoon regions of China. HIV-positive subjects tended to correlate with more severe manifestations of a tuberculosis/cryptococcosis co-infection than those without HIV. Notablely, dual tubercular/cryptococcal meningitis was the most frequent (54.0%) and most easily misdiagnosed (95.2%, n=40/42) co-infection. We also found that the combined use of cerebrospinal fluid pressure and concentrations of glucose, protein and chlorine might be an inexpensive and effective indicator to differentiate tubercular/cryptococcal co-infection meningitis from tubercular meningitis and cryptococcal meningitis.

An Overview of Coverage of BCG Vaccination and Its Determinants Based on Data from the Coverage Survey in Zhejiang Province

“…China is a high TB burden country with the third highest number of TB cases reported annually worldwide [ 16 , 17 ]. To date, the control strategies of TB include improvement and enhancement of access to medical treatment and prevention through BCG vaccination.…”

Cryptococcal Meningitis and Tuberculous Meningitis Co-infection in HIV-Infected Ugandan Adults

“…In a systematic review of TB/cryptococcosis infection in China, Fang et al identified 197 cases of co-infection, of whom 19% (n = 37) were in HIV-infected patients. TBM/CM was the most frequent co-infection (54%, 94/174) [ 4 ]. CM/TBM co-infection has been described in case reports in patients with a range of underlying immunodeficiencies, including HIV (n = 3) [ 5–7 ], systemic lupus erythematosus (n = 1), Waldenstrom’s macroglobulinemia (n = 1), and reticulum cell sarcoma (n = 1), and in patients with no underlying immunodeficiency (n = 2) [ 8 ].…”

Cryptococcosis and Tuberculosis Coinfection in a Regional Reference Service of HIV-AIDS from Southern Brazil

“…Cryptococcosis (Cr) and tuberculosis (TB) are infectious diseases potentially fatal to patients with acquired immunodeficiency syndrome (AIDS) by human immunodeficiency virus (HIV) infection. Both are widely distributed around the world and their diagnosis is recognized as a defining condition for AIDS [1][2][3].…”

“…In this context, such Cr as TB shows a high relevance in immunosuppressed patients and the coinfection with Cr/TB in endemic regions may represent a new challenge in the panorama of the HIV-AIDS pandemic [1,3,[8][9][10]. Thus, this study aims to describe the occurrence of all cases of Cr/TB coinfection in patients attending the Regional Reference Service of HIV-AIDS of a hospital in southern Brazil in a period of 3 years.…”