Prevalence of Crytpococcal Infection in Patients Clinically Diagnosed to Have Meningitis in Ethiopia
Clinical Medicine Research
Volume 5, Issue 4, July 2016, Pages: 73-76
Received: May 21, 2016;
Accepted: May 31, 2016;
Published: Jun. 14, 2016
Views 1519 Downloads 74
Adane Bitew, Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
Mulu Hassen, Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
Tigist Getachew, Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
Surafel Fentaw, Department of Clinical Bacteriology and Mycology, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Cryptococcal meningitis is a fungal infection that causes significant morbidity and mortality worldwide. However, its incidence in Ethiopia is poorly known. The present study was undertaken to determine cryptococcal meningitis in Ethiopian patients diagnosed to have meningitis. Cerebrospinal fluid was collected from 201 patients with meningitis attending two tertiary hospitals for the isolation and characterization of major bacterial pathogens implicated in causing meningitis. Left over sample of each patient was screened for cryptococal antigen using lateral flow Assay. Of the total number of 201 patients 17 (8.5%) were positive for cryptococcal antigenemia of which 8 (47.1%) were male patients while 9 (52.9%) were female patients. In conclusion a high prevalence of cryptococcal meningitis in the present study urges detection and /or isolation and characterization of the pathogen in patients diagnosed to have meningitis regardless of the immune status. Furthermore, in view of the increasing number of cryptococcal infections, rapid, sensitive, and specific diagnosis of cryptococcal disease has become more important than ever in Ethiopian health institutions.
Prevalence of Crytpococcal Infection in Patients Clinically Diagnosed to Have Meningitis in Ethiopia, Clinical Medicine Research.
Vol. 5, No. 4,
2016, pp. 73-76.
Dromer F, Mathoulin S, Dupont B, and Laporte A. “Epidemiology of cryptococcosis in France: a 9-year survey (1985– 1993). French Cryptococcosis Study Group.” Clin. Infec. Dis 1996, 23: 82–90.
Park BJ, Wannemuehler KA, Marston BJ, Govender N, Pappas PG, et al. Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS. AIDS 2009; 23: 525–530.
Bekondi C, Bernede C, Passone N, Minssart P, Kamalo C, Mbolidi D, Germani Y. Primary and opportunistic pathogens associated with meningitis in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus. Int J Infect Dis 2006; 10: 387–395.
Bogaerts J, Rouvroy D, Taelman H, Kagame A, Aziz MA, Swinne D, Verhaegen J. AIDS-associated cryptococcal meningitis in Rwanda (1983–1992): epidemiologic and diagnostic features. J Infect 1999; 39: 32–37.
Gordon SB, Walsh AL, Chaponda M, Gordon MA, Soko D, Mbwvinji M, et al. Bacterial meningitis in Malawian adults: pneumococcal disease is common, severe, and seasonal. Clin Infect Dis 2000; 31: 53–57.
Helbok R, Pongpakdee S, Yenjun S, Dent W, Beer R, Lackner P, et al. Chronic meningitis in Thailand. Clinical characteristics, laboratory data and outcome in patients with specific reference to tuberculosis and cryptococcosis. Neuroepidemiology 2006; 26: 37–44.
Heyderman RS, Gangaidzo IT, Hakim JG, Mielke J, Taziwa A, Musvaire P, et al. Cryptococcal meningitis in human immunodeficiency virus-infected patients in Harare, Zimbabwe. Clin Infect Dis 1998; 26: 284–289.
Hovette P, Soko TO, Raphenon G, Camara P, Burgel PR, Garraud O. Cryptococcal meningitis in AIDS patients: an emerging opportunistic infection in Senegal. Trans R Soc Trop Med Hyg 1999; 93: 368.
Schutte CM, Van der Meyden CH, Magazi DS. The impact of HIV on meningitis as seen at a South African Academic Hospital (1994 to 1998). Infection 2000; 28: 3–7.
Okongo M, Morgan D, Mayanja B, Ross A, Whitworth J. Causes of death in a rural, population-based human immunodeficiencyvirus type 1 (HIV-1) natural history cohort in Uganda. Int J Epidemiol 1998; 27: 698–702.
French N, Gray K, Watera C, Nakiyingi J, Lugada E, Moore M, et al. Cryptococcal infection in a cohort of HIV-1-infected Ugandan adults. AIDS 2002; 16: 1031–1038.
Corbett EL, Churchyard GJ, Charalambos S, Samb B, Moloi V, Clayton TC, et al. Morbidity and mortality in South African gold miners: impact of untreated disease due to humanimmunodeficiency virus. Clin Infect Dis 2002; 34: 1251–1258.
Shih CC, Chen YC, Chang SC, Luhi KT. Hsieh WC. Cryptococcal meningitis in non-HIV-infected patients. Q J Med 2000; 93: 245–251.
Lui G, Lee N, Ip M., Choi KW, Tso YK, Lam E, et al. Cryptococcosis in apparently immunocompetent patients Q J Med 2006; 99: 143–151.
Bello YB, Machado HG, Silveira JF, Schettini F, Junior GM, Junior SD et al., Cryptococcal meningitis in immunocompetent patient-case report. American Medical Journal 2013; 4: 100-104.
Lester FT. Cryptococcal meningitis complicating remoteskullfracture J. Neurology, Neurosurgery, and Psychiatry, 1978; 41: 672-673.
Gebremedhin ACryptococcal meningitis in a young Ethiopian woman with AIDS. Ethiop Med J. 199; l; 30: 169-73
Teshale S, Shitaye A., Abraham A, Atakilti A, Ermias D. Cryptococcal meningitis in patients with acquired immuno-deficiency syndrome in pre-HAART era at Gondar College of Medical Sciences Hospital north-west Ethiopia. Ethiop Med, J, 2010; 48: 5-15.
Alemu AS, Russell R, Kempker, Admasu T, Smitson C., Nega B et al. High Prevalence of Cryptococcal Antigenemia among HIV-infected Patients Receiving Antiretroviral Therapy in Ethiopia. PLoS ONE 8 (3): e58377.
Tafese B, Yimtubezinash W, Daniel A, Gonfa A, David Boulware R. Comparison of Cryptococcal Antigenemia between Antiretroviral Naı¨ve and Antiretroviral Experienced HIV Positive Patients at Two Hospitals in Ethiopia. PLoS ONE 8 (10): e75585.
Chen S, Sorrell T, Nimmo G, Speed B, Currie B, Ellis D et al. Epidemiology and host- and variety-dependent characteristics of infection due to Cryptococcus neoformans in Australia and New Zealand. Australasian Cryptococcal Study Group. Clin Infect Dis 2000; 31: 499–508.
Friedman GD, Jeffrey Fessel W, Udaltsova NV, Hurley LB. Cryptococcosis: the 1981–2000 epidemic. Mycoses 2005; 48: 122–125.
Bergemann A, Karstaedt AS. The spectrum of meningitis in a population with high prevalence of HIV disease. QJM. 1996; 499–504.
Hakim JG, Gangaidzo IT, Heyderman RS, Mielke J, Mushangi E, Taziwa A, et al. Impact of HIV infection on meningitis in Harare, Zimbabwe: a prospective study of 406 predominantly adult patients. AIDS. 2000; 14: 1401–7.
Silber E, Sonnenberg P, Ho KC, Koornhof HJ, Eintracht S, Morris L, et al. Meningitis in a community with a high prevalence of tuberculosis and HIV infection. J Neurol Sci. 1999; 162: 20–6
Jarvis JN, Meintjes G, Williams A, Brown Y, Crede T, Harrison TS. Adult meningitis in a setting of high HIV and TB prevalence: findings from 4961 suspected cases. BMC Infect Dis. 2010; 10: 67.
Cohen DB, Zijlstra EE, Mukaka M, Reiss M, Kamphambale S, Scholing M, et al. Diagnosis of cryptococcal and tuberculosis meningitis in a resource-limited African setting. Trop Med Int Health. 2010; 15: 910–917.
Mwaba P, Mwansa J, Chintu C, Pobee J, Scarborough M, Portsmouth S, Zumla A,. Clinical presentation, natural history, and cumulative death rates of 230 adults with primary cryptococcal meningitis in Zambian AIDS patients treated under local conditions. Postgrad Med J 2001; 77: 769–77.
Mahale K, S Patil S, Ravikumar, Nagabhushan, Ramanath Mahale R, prevalence of cryptococcal meningitis among immunocompetent and immunocompromised individuals in Bellary, South India – a Prospective Study Journal of Clinical and Diagnostic Research. 2012 May (Suppl-1), 6: 388-392.
Pappas PG, Perfect JR, Cloud GA, Larsen RA, Pankey GA, Lancaster DJ et al Cryptococcosis in human immunodeficiency virus-negative patients in the era of effective azole therapy. Clin Infect Dis 2001; 33: 690–699.
Prasad KN, Agarwal J, Nag VL, Verma AK, Dixit AK, Ayyagari A Cryptococcal infection in patients with clinically diagnosed meningitis in a tertiary care center. Neurology India, 2003; 51: 364-366.