Evidence map›Paper›PMID 38106376›Full record

ArticleSSM. Qualitative research in health2023

Pathways to care with HIV-associated cryptococcal meningitis in Botswana and Uganda: Findings from a qualitative methods study.

David S Lawrence, Agnes Ssali, Neo Moshashane, Georgina Nabaggala, Lebogang Maphane, Thomas S Harrison, David Meya, Joseph N Jarvis, Janet Seeley

Open access · goldAbstract read
In one paragraph

Article in SSM. Qualitative research in health, 2023. 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
1.1field-weighted citation impact, top 21% 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, 5 citations in OpenAlex.

  1. Article
  2. Article
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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

9 authors at 5 institutions in 3 countries.

David S LawrenceDepartment of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, UK.
Agnes SsaliSocial Aspects of Health Programme, MRC/UVRI & LSHTM Uganda Research Institute, Entebbe, Uganda.
Neo MoshashaneBotswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
Georgina NabaggalaSocial Aspects of Health Programme, MRC/UVRI & LSHTM Uganda Research Institute, Entebbe, Uganda.
Lebogang MaphaneBotswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
Thomas S HarrisonInstitute of Infection and Immunity, St George's University London, London, UK.
David MeyaInfectious Diseases Institute, Makerere University, Kampala, Uganda.
Joseph N JarvisDepartment of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, UK.
Janet SeeleySocial Aspects of Health Programme, MRC/UVRI & LSHTM Uganda Research Institute, Entebbe, Uganda.
London School of Hygiene & Tropical Medicine · GBBotswana Harvard AIDS Institute Partnership · BWInfectious Diseases Institute · UGSt George's, University of London · GBUganda Virus Research Institute · UG

Funding

Medical Research Council MR/V033417/1
6 · The paper itself

Abstract

HIV-associated cryptococcal meningitis remains a key driver of AIDS-related mortality. Mortality is twice as high in those who present later to care and with severe symptoms such as confusion. We embedded a qualitative methods study within a randomised controlled trial in Gaborone, Botswana and Kampala, Uganda with the aim of understanding pathways to care. We conducted in-depth interviews with trial participants and surrogate decision makers and analysed data thematically. Between January 2020 and June 2021 we interviewed 58 individuals. Pathways to care were prolonged because headaches were disregarded by participants and healthcare workers as a common occurrence with a broad differential diagnosis of predominantly benign aetiologies. There was also a lack of awareness of cryptococcal meningitis, and it was often after HIV was diagnosed or disclosed that the pathway accelerated, resulting in hospital admission. We outline key recommendations to reduce mortality and argue for the integration of social and behavioural interventions within differentiated service delivery models for advanced HIV disease.

Indexed as

Advanced HIV diseaseCryptococcal meningitisDifferentiated service deliveryHIVQualitative research

Identifiers

PMID38106376
PMCPMC10719890
OpenAlexW4387409211

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.