Evidence map›Paper›PMID 35353190›Full record

ArticleMedical mycology2022

Determinants of cryptococcal antigen (CrAg) screening uptake in Kampala, Uganda: An assessment of health center characteristics.

Diksha Srishyla, Gabriel Saemisch, Fred Turya, Elizabeth Nalintya, Samuel Jjunju, Enock Kagimu, Morris K Rutakingirwa, Caleb P Skipper, David R Boulware, David B Meya and 1 more

Open access · greenAbstract read
In one paragraph

Article in Medical mycology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 38% 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, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Cryptococcal meningitis.Nature reviews. Disease primers · 2023
    Review
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

11 authors at 2 institutions in 2 countries.

Diksha SrishylaDepartment of Medicine, University of Minnesota, Minneapolis, 55455, MN, USA.
Gabriel SaemischDepartment of Medicine, University of Minnesota, Minneapolis, 55455, MN, USA.
Fred TuryaInfectious Diseases Institute, Kampala, Uganda.
Elizabeth NalintyaInfectious Diseases Institute, Kampala, Uganda.
Samuel JjunjuInfectious Diseases Institute, Kampala, Uganda.
Enock KagimuInfectious Diseases Institute, Kampala, Uganda.
Morris K RutakingirwaInfectious Diseases Institute, Kampala, Uganda.
Caleb P SkipperDepartment of Medicine, University of Minnesota, Minneapolis, 55455, MN, USA.
David R BoulwareDepartment of Medicine, University of Minnesota, Minneapolis, 55455, MN, USA.
David B MeyaInfectious Diseases Institute, Kampala, Uganda.ORCID 0000-0002-8854-0321
Radha RajasinghamDepartment of Medicine, University of Minnesota, Minneapolis, 55455, MN, USA.ORCID 0000-0001-5531-0231
Infectious Diseases Institute · UGUniversity of Minnesota · US

Funding

NPGH LEADERs YR12: OBSSR (Greenberg, Ngwafong Mukere) & NIBIB (Lee)D43TW009345 · FIC · UNIVERSITY OF WASHINGTON · PI Dibyadyuti Datta, Chandy C. John · 2017 to 2026
$15.2M
Infectious Disease Training in Clinical InvestigationT32AI055433 · NIAID · UNIVERSITY OF MINNESOTA TWIN CITIES · PI David R Boulware · 2003 to 2026
$6.1M
Operational Research for Cryptococcal Antigen Screening (ORCAS) of HIV PatientsU01AI125003 · NIAID · UNIVERSITY OF MINNESOTA · PI BOULWARE, DAVID R, MEYA, DAVID BISAGAYA · 2016 to 2020
$3.4M
Evaluation of CRAG screening with enhanced antifungal therapy for asymptomatic CRAG-positive personsK23AI138851 · NIAID · UNIVERSITY OF MINNESOTA · PI RAJASINGHAM, RADHA · 2018 to 2022
$954k
FIC NIH HHS D43 TW009345NIAID NIH HHS K23 AI138851NIAID NIH HHS T32 AI055433NIAID NIH HHS U01 AI125003NIH HHS K23AI138851NINDS NIH HHS D43TW009345
6 · The paper itself

Abstract

Cryptococcal antigen (CrAg) screening and pre-emptive antifungal therapy for people with CD4 cell counts <100 cells/μl are recommended by the World Health Organization and several national HIV guidelines. We sought to evaluate CrAg screening program implementation across Uganda, in relation to health center level and distance from the capital. We conducted a cross-sectional study of 22 health centers across southern Uganda from April to June 2019. We reviewed laboratory records regarding number of CD4 cell count tests performed, proportion of outpatients with CD4 counts <200 cells/μl, and number of CrAg screening tests performed. We administered surveys to health center staff to understand barriers to advanced HIV care. We observed no significant difference in health center level and performance of CrAg screening; with each subsequent health center level, there was 1.17-fold (95% CI: 0.92-1.41) higher odds of CrAg screening performed per level. CrAg screening uptake was not associated with distance from the capital city (odds ratio = 0.96, 95% CI: 0.89-1.04). Qualitative data from surveys indicated that limitations to uptake of CrAg screening were secondary to dysfunctional CD4 machines, lack of provider awareness of CrAg screening guidelines, and inadequate/intermittent supply of CrAg tests. There were no significant associations between CrAg screening uptake and level of health center or distance of health center from the capital city. We identified systemic barriers to CrAg screening related to inadequate CD4 testing, insufficient knowledge regarding national screening guidelines, and irregular laboratory testing supplies. LAY SUMMARY: The objective of this study was to evaluate cryptococcal antigen (CrAg) screening program implementation in Uganda, by type of healthcare center and by distance from the capital city. CrAg screening uptake was not associated with distance from the capital city, or the type of healthcare center.

Indexed as

CryptococcusMeningitis, CryptococcalAnimalsAntigens, FungalCross-Sectional StudiesHumansUgandaAntigens, Fungaladvanced HIV diseasecryptococcal meningitisCryptococcal screeningimplementation science

Identifiers

PMID35353190
PMCPMC8973400
OpenAlexW4220907101

What OpenQuestion holds

Textmetadata
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.