Abstract
Cryptococcal meningitis (CM) is a major cause of death among HIV-infected persons in sub-Saharan Africa. We conducted a study to describe the long-term outcomes during the pre-antiretroviral post-ART therapy period. Enrolled cases were those detected through population-based surveillance in Gauteng Province, South Africa, and diagnosed during March-November 2002 and July-September 2003 from eight large hospitals representing academic, provincial and rural settings. Of 1089 case-patients diagnosed with CM, 721 (70%) survived to discharge. Among the 256 with follow-up information, 154 (60%) were established to have died, 44% of whom died as outpatients. Overall, the 14- and 90-day survival post-diagnosis was 68% and 41%, respectively. On Cox proportional hazards multivariable analysis, severe disease was associated with shorter survival time; having received any antifungal treatment for the cryptococcal episode was associated with increased survival time at follow-up. Although most patients in this cohort survived the initial hospitalization, only 41% were still alive three months after diagnosis, with nearly half of deaths occurring outside a hospital. These data are an important baseline from which to measure effectiveness of public health management of CM in South Africa.
Original language | English (US) |
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Pages (from-to) | 199-203 |
Number of pages | 5 |
Journal | International Journal of STD and AIDS |
Volume | 22 |
Issue number | 4 |
DOIs | |
State | Published - Apr 2011 |
Externally published | Yes |
Keywords
- AIDS
- Cryptococcal meningitis
- Cryptococcosis
- Cryptococcus
- HIV
- South Africa
- Survival
ASJC Scopus subject areas
- Dermatology
- Public Health, Environmental and Occupational Health
- Infectious Diseases
- Pharmacology (medical)