Prevalence of cryptococcal antigen (CrAg) among HIV-positive patients in Eswatini, 2014–2015

African Journal of Laboratory Medicine

 
 
Field Value
 
Title Prevalence of cryptococcal antigen (CrAg) among HIV-positive patients in Eswatini, 2014–2015
 
Creator Haumba, Samson M. Toda, Mitsuru Jeffries, Rossana Ehrenkranz, Peter Pasipamire, Munyaradzi Ao, Trong Lukhele, Nomthandazo Mazibuko, Sikhathele Mkhontfo, Mandzisi Smith, Rachel M. Chiller, Tom
 
Subject Health studies; Laboratory studies; Sensitivity and specificity studies cryptococcal antigenaemia screening; prevalence; people living with HIV; cryptococcal meningitis; advanced HIV disease package; Eswatini
Description Background: Cryptococcal meningitis is a leading cause of death amongst people living with HIV. However, routine cryptococcal antigen (CrAg) screening was not in the national guidelines in Eswatini.Objectives: A cross-sectional study was conducted between August 2014 and March 2015 to examine CrAg prevalence at Mbabane Government Hospital in Eswatini.Methods: We collected urine and whole blood from antiretroviral-therapy-naïve patients with HIV and a cluster of differentiation 4 (CD4) counts 200 cells/mm3 for plasma and urine CrAg lateral flow assay (LFA) screening at the national HIV reference laboratory. Two CD4 cut-off points were used to estimate CrAg prevalence: CD4 100 and 200 cells/mm3. Sensitivity and specificity of urine CrAg LFA was compared to plasma CrAg LFA.Results: Plasma CrAg prevalence was 4% (8/182, 95% confidence interval [CI]: 2–8) amongst patients with CD4 counts of 200 cells/mm3, and 8% (8/102, 95% CI: 3–15) amongst patients with CD4 counts of 100 cells/mm3. Urine CrAg LFA had a sensitivity of 100% (95% CI: 59–100) and a specificity of 80% (95% CI: 72–86) compared with plasma CrAg LFA tests for patients with CD4 200 cells/mm3. Forty-three per cent of 99 patients with CD4 100 were at World Health Organization clinical stages I or II.Conclusion: The prevalence of CrAg in Eswatini was higher than the current global estimate of 6% amongst HIV-positive people with CD4 100 cell/mm3, indicating the importance of initiating a national screening programme. Mechanisms for CrAg testing, training, reporting, and drug and commodity supply issues are important considerations before national implementation.
 
Publisher AOSIS
 
Contributor Funded the US Centers for Disease Control and Prevention (CDC) through University Research Co., LLC (URC) and African Society for Laboratory Medicine (ASLM) Contributions from Samson Haumba-URC Rosanna Jeffries-URC Mitsuru Toda-CDC Tom Chiller-CDC
Date 2020-07-29
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — cross-sectional study
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/ajlm.v9i1.933
 
Source African Journal of Laboratory Medicine; Vol 9, No 1 (2020); 7 pages 2225-2010 2225-2002
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://ajlmonline.org/index.php/ajlm/article/view/933/1544 https://ajlmonline.org/index.php/ajlm/article/view/933/1543 https://ajlmonline.org/index.php/ajlm/article/view/933/1545 https://ajlmonline.org/index.php/ajlm/article/view/933/1542
 
Coverage Southern Africa; Eswatini Screening; Antigenemia; Preemptive treatment HIV status, HIV staging by CD4 cell count; WHO HIV clinical staging; gender; Age
Rights Copyright (c) 2020 Samson M. Haumba, Mitsuru Toda, Rossana Jeffries, Peter Ehrenkranz, Munyaradzi Pasipamire, Trong Ao, Nomthandazo Lukhele, Sikhathele Mazibuko, Mandzisi Mkhontfo, Rachel M. Smith, Tom Chiller https://creativecommons.org/licenses/by/4.0
ADVERTISEMENT