ArticleOpen forum infectious diseases2019
The Changing Epidemiology of HIV-Associated Adult Meningitis, Uganda 2015-2017.
Article in Open forum infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 46 papers.
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Who cites it
46 citing papers in PubMed, 57 citations in OpenAlex.
- Enhancing meningitis diagnosis: a diagnostic stewardship workflow in a resource-limited setting.Microbiology spectrum · 2026Article
- HIV-Associated Cryptococcal Meningitis: A Call for Action for New Treatment Options.Therapeutics · 2026Article
- NMD-mediated control of Tor influences adaptation to nutrient and temperature conditions inbioRxiv : the preprint server for biology · 2026Article
- Prevalence of CSF HIV VIRAL Escape and Associations With Neurocognitive Outcomes Among HIV-Associated Meningitis Survivors: A Cohort Study.Open forum infectious diseases · 2026Article
- 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
- Characteristics and Distribution of Fungal Meningitis: A Systematic Review.Infectious diseases & clinical microbiology · 2025Article
- "Utility of Cerebrospinal Fluid Unstimulated Interferon-Gamma (IRISA-TB) as a Same-Day Test for Tuberculous Meningitis in a Tuberculosis-Endemic, Resource-Poor Setting".Open forum infectious diseases · 2025Article
- Cerebrospinal Fluid Cytokines and Chemokines Involved in Cytotoxic Cell Function and Risk of Acute 14-Day Mortality in Persons with Advanced HIV and Cryptococcal Meningitis.The Journal of infectious diseases · 2025Article
- Experiences, challenges, gaps, and strategies for counselling persons presenting with advanced HIV-associated meningitis in Uganda.AIDS research and therapy · 2025Article
- Neurocognitive Impairment Among Cryptococcal Meningitis Survivors in Uganda, a Prospective Cohort Study.Open forum infectious diseases · 2025Article
- Efficacy and Safety of Long-acting Injectable Cabotegravir and Rilpivirine in Improving HIV-1 Control in sub-Saharan Africa: Protocol for a Phase 3b Open-Label Randomized Controlled Trial (IMPALA).Wellcome open research · 2025Article
- The evolution of HIV-associated cryptococcal meningitis in Uganda from 2010 to 2022.Medical mycology · 2024Article
- State of the Field: Cytotoxic Immune Cell Responses inJournal of fungi (Basel, Switzerland) · 2024Review
- The Impact of GeneXpert Cerebrospinal Fluid Testing on Tuberculous Meningitis Diagnosis in Routine Care in Botswana.Open forum infectious diseases · 2024Article
- Baseline C-reactive Protein as a Risk Factor for Cryptococcal Meningitis and Death in HIV-associated Cryptococcal Antigenemia With CrAg Titer as an Effect Modifier.Open forum infectious diseases · 2024Article
- Complex Decisions in HIV-Related Cryptococcosis: Addressing Second Episodes of Cryptococcal Meningitis.Current HIV/AIDS reports · 2024Review
- 5-Flucytosine Longitudinal Antifungal Susceptibility Testing ofOpen forum infectious diseases · 2023Article
- Cryptococcal meningitis.Nature reviews. Disease primers · 2023Review
- Recurrence of Symptoms Following Cryptococcal Meningitis: Characterizing a Diagnostic Conundrum With Multiple Etiologies.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Cytomegalovirus viremia and advanced HIV disease: is there an argument for anti-CMV treatment?Expert review of anti-infective therapy · 2023Review
Corrections and comments
- Erratum issued
Authors and funding
12 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundCentral nervous system (CNS) infections remain a major public health problem in Sub-Saharan Africa, causing 15%-25% of AIDS-related deaths. With widespread availability of antiretroviral therapy (ART) and the introduction of improved diagnostics, the epidemiology of infectious meningitis is evolving.
methodsWe prospectively enrolled adults presenting with HIV-associated meningitis in Kampala and Mbarara, Uganda, from March 2015 to September 2017. Participants had a structured, stepwise diagnostic algorithm performed of blood cryptococcal antigen (CrAg), CSF CrAg, Xpert MTB/RIF for tuberculous (TB) meningitis (TBM), Biofire multiplex polymerase chain reaction, and traditional microscopy and cultures.
resultsWe screened 842 consecutive adults with HIV presenting with suspected meningitis: 57% men, median age 35 years, median CD4 26 cells/mcL, and 55% presented on ART. Overall, 60.5% (509/842) were diagnosed with first-episode cryptococcal meningitis and 7.4% (62/842) with second episode. Definite/probable TB meningitis was the primary diagnosis in 6.9% (58/842); 5.3% (n = 45) had microbiologically confirmed (definite) TB meningitis. An additional 7.8% (66/842) did not meet the diagnostic threshold for definite/probable TBM but received empiric TBM therapy. Bacterial and viral meningitis were diagnosed in 1.3% (11/842) and 0.7% (6/842), respectively. The adoption of a cost-effective stepwise diagnostic algorithm allowed 79% (661/842) to have a confirmed microbiological diagnosis at an average cost of $44 per person.
conclusionsDespite widespread ART availability,
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