Evidence map›Paper›PMID 41377594›Full record

ArticleOpen forum infectious diseases2025

Assessment of Clinical Guideline Use in the Prevention, Diagnosis, and Treatment of Cryptococcal Meningitis Among Health Care Providers in Ethiopia.

Blen M Gebresilassie, Gerome B Vallejos, Ryan S Walker, Omosefe Noruwa, Kathryn B Holroyd, Temesgen Nurye, Carla Kim, Biniyam Ayele, Kiran T Thakur

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In one paragraph

Article in Open forum infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

9 authors.

Blen M GebresilassieAmanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.
Gerome B VallejosProgram in Neuroinfectious Diseases, Department of Neurology, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, New York, USA.ORCID https://orcid.org/0000-0001-6006-3909
Ryan S WalkerProgram in Neuroinfectious Diseases, Department of Neurology, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, New York, USA.
Omosefe NoruwaProgram in Neuroinfectious Diseases, Department of Neurology, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, New York, USA.ORCID https://orcid.org/0009-0008-8324-1868
Kathryn B HolroydProgram in Neuroinfectious Diseases, Department of Neurology, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, New York, USA.
Temesgen NuryeProgram in Neuroinfectious Diseases, Department of Neurology, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, New York, USA.
Carla KimProgram in Neuroinfectious Diseases, Department of Neurology, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, New York, USA.ORCID https://orcid.org/0000-0001-5714-7212
Biniyam AyeleGlobal Brain Health Institute (GBHI), University of California, San Francisco (UCSF), San Francisco, California, USA.ORCID https://orcid.org/0000-0002-7955-6030
Kiran T ThakurProgram in Neuroinfectious Diseases, Department of Neurology, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, New York, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Cryptococcal meningitis (CM) is a significant cause of morbidity and mortality in individuals with advanced HIV. Ethiopia, with a high HIV burden and significant socioeconomic challenges, has limited data on CM. Understanding clinical practices is crucial to identifying gaps and improving disease management. Methods: A survey was conducted among health care workers (HCWs), microbiologists, and pharmacists across 9 Ethiopian health facilities from July to November 2024. Eligibility required active involvement in HIV or CM care. Ethics approval and informed consent were secured. Three profession-specific questionnaires were used to assess knowledge of CM care and challenges. Data were analyzed in R, version 4.3.2. Results: A total of 311 participants were included: HCWs, n = 202; microbiologists, n = 65; and pharmacists, n = 44. Most participants, 188/202 (93.1%) HCWs, 42/44 (95.5%) pharmacists, and 54/65 (83.1%) microbiologists, recognized the need for additional guideline training. Only 59/202 (29%) HCWs reported that screening for cryptococcal antigenemia was always performed. Among antifungals, fluconazole was the most available, with 21/44 (48%) pharmacists and 49/202 (24%) HCWs reporting it as always in stock. Liposomal amphotericin B (L-Amb) was reported as available by only 7/44 (16%) pharmacists and 44/202 (22%) HCWs. The most significant barriers to guideline implementation were insufficient policy support and challenges in integrating guidelines into electronic health records, as reported by 152/202 (75.2%) and 143/202 (70.8%) HCWs, respectively. Conclusions: There are substantial gaps in CM care, highlighting the importance of improving resource allocation, technical assistance, additional training, and financial support.

Indexed as

clinical guidelinescryptococcal meningitisEthiopiahealth care practicesHIV

Identifiers

PMID41377594
PMCPMC12687586

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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.