ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
Advanced Human Immunodeficiency Virus Disease in Botswana Following Successful Antiretroviral Therapy Rollout: Incidence of and Temporal Trends in Cryptococcal Meningitis.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.
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Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Cryptococcosis-a systematic review to inform the World Health Organization Fungal Priority Pathogens List.Medical mycology · 2024Pooled it
- Equity in clinical trials for HIV-associated cryptococcal meningitis: A systematic review of global representation and inclusion of patients and researchers.PLoS neglected tropical diseases · 2021Pooled it
- Primary antifungal prophylaxis for cryptococcal disease in HIV-positive people.The Cochrane database of systematic reviews · 2018Pooled it
- How Applicable Is the Single-Dose AMBITION Regimen for Human Immunodeficiency Virus-Associated Cryptococcal Meningitis to High-Income Settings?Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Trial
- Single-Dose Liposomal Amphotericin B Treatment for Cryptococcal Meningitis.The New England journal of medicine · 2022Trial
- Epstein-Barr Virus Central Nervous System Infections and Mortality Risk in Patients Presenting With Suspected Meningitis: Results From the Botswana National Meningitis Survey and the Harare Meningitis Aetiology Study.Open forum infectious diseases · 2025Article
- Target product profile and discovery and development path for novel cryptococcal disease treatments.The Journal of infection · 2025Review
- Environmental sources of Cryptococcus neoformans species complex in Kampala, Uganda: A preliminary study.PloS one · 2025Article
- Tracking Cryptococcal Meningitis to Monitor HIV Program Success During the Treat All Era: An Analysis of National Data in Botswana.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- The association between fear of progression and medical coping strategies among people living with HIV: a cross-sectional study.BMC public health · 2024Article
- The incidences and clinical outcomes of cryptococcosis in Taiwan: A nationwide, population-based study, 2002-2015.Medical mycology · 2024Article
- Article
- Pathways to care with HIV-associated cryptococcal meningitis in Botswana and Uganda: Findings from a qualitative methods study.SSM. Qualitative research in health · 2023Article
- Six months survival and risk factors for attrition for patients detected with cryptococcal antigenemia through screening in Malawi.PloS one · 2023Article
- A multicenter survey of asymptomatic cryptococcal antigenemia among patients with advanced HIV disease in Nigeria.PLOS global public health · 2023Article
- The acceptability of the AMBITION-cm treatment regimen for HIV-associated cryptococcal meningitis: Findings from a qualitative methods study of participants and researchers in Botswana and Uganda.PLoS neglected tropical diseases · 2022Article
- Integrated healthcare approach can curb the increasing cases of cryptococcosis in Africa.PLoS neglected tropical diseases · 2022Article
- Epidemiology and Mortality of Cryptococcal Disease in Guatemala: Two-Year Results of a Cryptococcal Antigen Screening Program.Microorganisms · 2022Article
- Reversal of CSF HIV-1 Escape during Treatment of HIV-Associated Cryptococcal Meningitis in Botswana.Biomedicines · 2022Article
- Short-term Mortality Outcomes of HIV-Associated Cryptococcal Meningitis in Antiretroviral Therapy-Naïve and -Experienced Patients in Sub-Saharan Africa.Open forum infectious diseases · 2021Article
Corrections and comments
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Authors and funding
23 authors at 12 institutions in 5 countries.
Funding
Abstract
Background: Botswana has a well-developed antiretroviral therapy (ART) program that serves as a regional model. With wide ART availability, the burden of advanced human immunodeficiency virus (HIV) and associated opportunistic infections would be expected to decline. We performed a nationwide surveillance study to determine the national incidence of cryptococcal meningitis (CM), and describe characteristics of cases during 2000-2014 and temporal trends at 2 national referral hospitals. Methods: Cerebrospinal fluid data from all 37 laboratories performing meningitis diagnostics in Botswana were collected from the period 2000-2014 to identify cases of CM. Basic demographic and laboratory data were recorded. Complete national data from 2013-2014 were used to calculate national incidence using UNAIDS population estimates. Temporal trends in cases were derived from national referral centers in the period 2004-2014. Results: A total of 5296 episodes of CM were observed in 4702 individuals; 60.6% were male, and median age was 36 years. Overall 2013-2014 incidence was 17.8 (95% confidence interval [CI], 16.6-19.2) cases per 100000 person-years. In the HIV-infected population, incidence was 96.8 (95% CI, 90.0-104.0) cases per 100000 person-years; male predominance was seen across CD4 strata. At national referral hospitals, cases decreased during 2007-2009 but stabilized during 2010-2014. Conclusions: Despite excellent ART coverage in Botswana, there is still a substantial burden of advanced HIV, with 2013-2014 incidence of CM comparable to pre-ART era rates in South Africa. Our findings suggest that a key population of individuals, often men, is developing advanced disease and associated opportunistic infections due to a failure to effectively engage in care, highlighting the need for differentiated care models.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.