The Impact of HIV on Meningitis as Seen at a South African Academic Hospital (1994 to 1998)

Schutte, Clara-Maria; Meyden, C. H. Van Der; Magazi, D.S.

doi:10.1007/pl00012241

Cited by 30 publications

(32 citation statements)

References 11 publications

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“…neoformans caused a high proportion of cases of meningitis among HIV-1-infected patients, and the high associated case-fatality rate reflects, in part, the absence of affordable treatment [69][70][71]73]. Although PCP did not have a similar impact on mortality (as assessed by autopsy data), it was probably underdiagnosed as a result of the limited invasive testing in sub-Saharan Africa [25,[76][77][78] and may often be partially treated, given the frequency of use of TMP-SMZ and other antibiotics in the region.…”

Section: Burden Of Illnessmentioning

confidence: 99%

“…In studies of suspected cases of meningitis in HIV-1-infected patients, the prevalence of cryptococcal meningitis was 0% in Ghana (using only India ink staining for diagnosis) [68], 25% in Ethiopia [69], and 12%-50% in South Africa (determined by means of staining, latex agglutination testing, and culture) [70,71]. Six percent of patients admitted to a general medicine ward in the Democratic Republic of Congo were diagnosed [72].…”

Section: Neoformansmentioning

confidence: 99%

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Review of Human Immunodeficiency Virus Type 1–Related Opportunistic Infections in Sub‐Saharan Africa

et al. 2003

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Understanding the natural history of human immunodeficiency virus type 1 (HIV-1) and opportunistic infections in sub-Saharan Africa is necessary to optimize strategies for the prophylaxis and treatment of opportunistic infections and to understand the likely impact of antiretroviral therapy. We undertook a systematic review of the literature on HIV-1 infection in sub-Saharan Africa to assess data from recent cohorts and selected cross-sectional studies to delineate rates of opportunistic infections, associated CD4 cell counts, and associated mortality. We searched the MEDLINE database and the Cochrane Database of Systematic Reviews and Cochrane Clinical Trials Register for English-language literature published from 1990 through April 2002. Tuberculosis, bacterial infections, and malaria were identified as the leading causes of HIV-related morbidity across sub-Saharan Africa. Of the few studies that reported CD4 cell counts, the range of cell counts at the time of diagnosis of opportunistic infections was wide. Policies regarding the type and timing of opportunistic infection prophylaxis may be region specific and urgently require further study.

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Section: Burden Of Illnessmentioning

confidence: 99%

Section: Neoformansmentioning

confidence: 99%

Review of Human Immunodeficiency Virus Type 1–Related Opportunistic Infections in Sub‐Saharan Africa

et al. 2003

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“…In South Africa alone, an estimated 5.7 million people, approximately 12% of the population, are seropositive for HIV (64,65). Many of these deaths are related to AIDS-defining infections, particularly tuberculosis and cryptococcosis (12,26,28,57,59). Both infections are acquired by inhalation, but cryptococcosis is not contagious.…”

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confidence: 99%

Analyses of Pediatric Isolates of Cryptococcus neoformans from South Africa

et al. 2011

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Compared to the incidence in adults, cryptococcosis is inexplicably rare among children, even in subSaharan Africa, which has the highest prevalence of coinfection with HIV and Cryptococcus neoformans. To explore any mycological basis for this age-related difference in the incidence of cryptococcosis, we investigated isolates of C. neoformans recovered from pediatric and adult patients during a 2-year period in South Africa. From reports to the Group for Enteric, Respiratory, and Meningeal Disease Surveillance in South Africa (GERMS-SA), we reviewed all cases of cryptococcosis in 2005 and 2006. We analyzed one isolate of C. neoformans from each of 82 pediatric patients (<15 years of age) and determined the multilocus sequence type (ST), mating type, ploidy, and allelic profile. This sample included isolates of all three molecular types of serotype A or C. neoformans var. grubii (molecular types VNI, VNII, and VNB) and one AD hybrid. Seventyseven (94%) of the strains possessed the MAT␣ mating type allele, and five were MATa. Seventy-five (91%) were haploid, and seven were diploid. A total of 24 different STs were identified. The ratios of each mating type and the proportion of haploids were comparable to those for the isolates that were obtained from 86 adult patients during the same period. Notably, the most prevalent pediatric ST was significantly associated with male patients. Overall, these pediatric isolates exhibited high genotypic diversity. They included a relatively large percentage of diploids and the rarely reported MATa mating type.

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“…In Durban, South Africa, cryptococcal meningitis was the initial AIDS-defining illness in 84% of HIV patients, 1 while in Pretoria it was found to be the presenting cause for patients with HIV and meningitis in 50% of patients. 2 Its incidence at Pretoria academic hospitals has more than doubled over the past year (Levay, unpublished findings). The clinical presentation of patients with cryptococcal meningitis varies from headache (>95%) to coma.…”

Section: Do Normal C-reactive Protein Levels Exclude the Diagnosis Ofmentioning

confidence: 99%

Do normal C-reactive protein levels exclude the diagnosis of cryptococcal meningitis?

Levay

Gryffenberg

2006

South African Family Practice

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The Impact of HIV on Meningitis as Seen at a South African Academic Hospital (1994 to 1998)

Abstract: Over a 4-year period the HIV epidemic was responsible for a marked shift in the spectrum of meningitis towards chronic infections such as TB and cryptococcal meningitis at the PAH.

Cited by 30 publications

References 11 publications

Review of Human Immunodeficiency Virus Type 1–Related Opportunistic Infections in Sub‐Saharan Africa

Review of Human Immunodeficiency Virus Type 1–Related Opportunistic Infections in Sub‐Saharan Africa

Analyses of Pediatric Isolates of Cryptococcus neoformans from South Africa

Do normal C-reactive protein levels exclude the diagnosis of cryptococcal meningitis?

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