Title: Poor long-term outcomes for cryptococcal meningitis in rural South Africa
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
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-
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
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
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
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).