Evidence map›Paper›PMID 33882845›Full record

ArticleBMC infectious diseases2021

Ambulatory induction phase treatment of cryptococcal meningitis in HIV integrated primary care clinics, Yangon, Myanmar.

Clare E Warrell, Catriona Macrae, Alistair R D McLean, Edmund Wilkins, Elizabeth A Ashley, Frank Smithuis, Ni Ni Tun

Open access · goldAbstract read
In one paragraph

Article in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 3 countries.

Clare E WarrellMyanmar Oxford Clinical Research Unit (MOCRU), Yangon, Myanmar. c.warrell@nhs.net.ORCID http://orcid.org/0000-0003-0633-0986
Catriona MacraeMedical Action Myanmar, Yangon, Myanmar.
Alistair R D McLeanMyanmar Oxford Clinical Research Unit (MOCRU), Yangon, Myanmar.
Edmund WilkinsMedical Action Myanmar, Yangon, Myanmar.
Elizabeth A AshleyMyanmar Oxford Clinical Research Unit (MOCRU), Yangon, Myanmar.
Frank SmithuisMyanmar Oxford Clinical Research Unit (MOCRU), Yangon, Myanmar.
Ni Ni TunMedical Action Myanmar, Yangon, Myanmar.
Myanmar Oxford Clinical Research Unit · MMUniversity of Oxford · GBMahosot Hospital · LA

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundCryptococcal meningitis (CM) is a common HIV-associated opportunistic-infection worldwide. Existing literature focusses on hospital-based outcomes of induction treatment. This paper reviews outpatient management in integrated primary care clinics in Yangon.

methodThis retrospective case note review analyses a Myanmar HIV-positive patient cohort managed using ambulatory induction-phase treatment with intravenous amphotericin-B-deoxycholate (0.7-1.0 mg/kg) and oral fluconazole (800 mg orally/day).

resultsSeventy-six patients were diagnosed between 2010 and 2017. The median age of patients diagnosed was 35 years, 63% were male and 33 (45%) were on concurrent treatment for tuberculosis. The median CD4 count was 60 at the time of diagnosis. Amphotericin-B-deoxycholate infusions precipitated 56 episodes of toxicity, namely hypokalaemia, nephrotoxicity, anaemia, febrile reactions, phlebitis, observed in 44 patients (58%). One-year survival (86%) was higher than existing hospital-based treatment studies.

conclusionAmbulation of patients in this cohort saved 1029 hospital bed days and had better survival outcomes when compared to hospital-based studies in other resource constrained settings.

Indexed as

HIVPrimary Health CareAdministration, IntravenousAdministration, OralAdolescentAdultAIDS-Related Opportunistic InfectionsAmphotericin BAntifungal AgentsCryptococcus neoformansDeoxycholic AcidDrug CombinationsDrug Therapy, CombinationFemaleFluconazoleHumansAmphotericin Bamphotericin B, deoxycholate drug combinationAntifungal AgentsDeoxycholic AcidDrug CombinationsFluconazoleCryptococcal meningitisHIVOpportunistic infections

Identifiers

PMID33882845
PMCPMC8059000
OpenAlexW3153966761

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.