dc.contributor.author | Loyse, Angela | |
dc.contributor.author | Burry, Jessica | |
dc.contributor.author | Cohn, Jennifer | |
dc.contributor.author | Ford, Nathan | |
dc.contributor.author | Chiller, Tom | |
dc.contributor.author | Ribeiro, Isabela | |
dc.contributor.author | Koulla-Shiro, Sinata | |
dc.contributor.author | Muzoora, Conrad | |
dc.date.accessioned | 2023-02-02T12:14:53Z | |
dc.date.available | 2023-02-02T12:14:53Z | |
dc.date.issued | 2019 | |
dc.identifier.citation | Loyse, A., Burry, J., Cohn, J., Ford, N., Chiller, T., Ribeiro, I., ... & Harrison, T. S. (2019). Leave no one behind: response to new evidence and guidelines for the management of cryptococcal meningitis in low-income and middle-income countries. The Lancet infectious diseases, 19(4), e143-e147. | en_US |
dc.identifier.uri | http://ir.must.ac.ug/xmlui/handle/123456789/2754 | |
dc.description.abstract | In 2018, WHO issued guidelines for the diagnosis, prevention, and management of HIV-related cryptococcal disease. Two strategies are recommended to reduce the high mortality associated with HIV-related cryptococcal meningitis in low-income and middle-income countries (LMICs): optimised combination therapies for confirmed meningitis cases and cryptococcal antigen screening programmes for ambulatory people living with HIV who access care. WHO’s preferred therapy for the treatment of HIV-related cryptococcal meningitis in LMICs is 1 week of amphotericin B plus flucytosine, and the alternative therapy is 2 weeks of fluconazole plus flucytosine. In the ACTA trial, 1-week (short course) amphotericin B plus flucytosine resulted in a 10-week mortality of 24% (95% CI –16 to 32) and 2 weeks of fluconazole and flucytosine resulted in a 10-week mortality of 35% (95% CI –29 to 41). However, with widely used fluconazole monotherapy, mortality because of HIV-related cryptococcal meningitis is approximately 70% in many African LMIC settings. Therefore, the potential to transform the management of HIV-related cryptococcal meningitis in resource limited settings is substantial. Sustainable access to essential medicines, including flucytosine and amphotericin B, in LMICs is paramount and the focus of this Personal View | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | The Lancet infectious diseases | en_US |
dc.subject | Cryptococcal meningitis | en_US |
dc.subject | WHO | en_US |
dc.subject | Diagnosis | en_US |
dc.subject | Prevention | en_US |
dc.subject | Management | en_US |
dc.subject | HIV | en_US |
dc.title | Leave no one behind: response to new evidence and guidelines for the management of cryptococcal meningitis in low-income and middle-income countries | en_US |
dc.type | Article | en_US |