Publication
Title: Poor long-term outcomes for cryptococcal meningitis in rural South Africa Objectives. To explore linkage to and retention in HIV care after an
episode of cryptococcal meningitis (CM) in rural South Africa. Design. A retrospective case series of adult individuals (?16 years
old) with laboratory-confirmed CM from January - December
2007 at Hlabisa Hospital ? a district hospital in northern KwaZulu-
Natal. Outcome measures. Inpatient mortality and associated risk factors
were analysed. The proportion alive and on antiretroviral therapy
(ART) at 2 years was determined by linkage to the HIV treatment
programme. Results. One hundred and four individuals were identified with
laboratory diagnosis of CM; 74/104 (71.2%) with complete records
were included in the analysis. Inpatient mortality was high (40.5%)
and was significantly associated with reduced conscious level (aHR
3.09, 95% CI 1.30 - 7.33) and absence of headache (aHR 0.33 for
headache, 95% CI 0.13 - 0.87). Only 8 individuals (10.8% of all
study subjects) were alive and receiving ART 2 years after the CM
episode. Conclusions. Long-term outcomes of CM are poor in routine
practice. Interventions to strengthen linkage to HIV treatment and
care and continuation of secondary fluconazole prophylaxis are
critical.
Authors: Lessells RJ, Mutevedzi PC, Heller T, Newell ML.
Journal: S Afr Med,101:251-2 (2011)
Journal Impact Factor (I.F.): 1.676
Number of citations (Google Scholar): 7 Abstract
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Citation: Lessells RJ, Mutevedzi PC, Heller T, Newell ML. Poor long-term outcomes for cryptococcal meningitis in rural South Africa S Afr Med,101:251-2 (2011).