23 research outputs found
Annual candidemia incidence rates per 100,000 person-years, by year and age-group in the Metropolitan Baltimore area.
<p>Annual candidemia incidence rates per 100,000 person-years, by year and age-group in the Metropolitan Baltimore area.</p
Candidemia cases that had a CVC compared with cases that had no CVC, in Atlanta (ATL) and Baltimore (BTM), 2008–2013.
<p>Candidemia cases that had a CVC compared with cases that had no CVC, in Atlanta (ATL) and Baltimore (BTM), 2008–2013.</p
Changes in candidemia case count at participating hospitals over the five-year study period (2008–2013), by the total number of cases each hospital contributed during the study.
<p>Changes in candidemia case count at participating hospitals over the five-year study period (2008–2013), by the total number of cases each hospital contributed during the study.</p
Selected characteristics of patients with candidemia in Atlanta and Baltimore metropolitan areas.
<p>*16/17 isolates were <i>C</i>. <i>glabrata</i> species</p><p>Selected characteristics of patients with candidemia in Atlanta and Baltimore metropolitan areas.</p
Annual candidemia incidence rates per 100,000 person-years, by year and age-group in the Metropolitan Atlanta area.
<p>Annual candidemia incidence rates per 100,000 person-years, by year and age-group in the Metropolitan Atlanta area.</p
Annual candidemia incidence rates per 100,000 person-years, by year and location, 2008–2013.
<p>Annual candidemia incidence rates per 100,000 person-years, by year and location, 2008–2013.</p
Selected characteristics of candidemia patients by year of surveillance, in Atlanta (ATL) and Baltimore (BTM) metropolitan areas.
<p><b><i>Note</i>:</b><i>HO</i>, <i>healthcare onset</i>. <i>HACO</i>, <i>healthcare-associated community-onset</i>. <i>CA</i>, <i>community-acquired</i>. <i>Ab surgery</i>, <i>abdominal surgery</i>. <i>Y</i>, <i>year</i>.</p><p>Selected characteristics of candidemia patients by year of surveillance, in Atlanta (ATL) and Baltimore (BTM) metropolitan areas.</p
Prevalence and correlates of CrAg positivity among HIV-infected adults with advanced immunosuppression in Namibia, 2013–14.
<p>Prevalence and correlates of CrAg positivity among HIV-infected adults with advanced immunosuppression in Namibia, 2013–14.</p
Select demographic and clinical characteristics of sampled patients, sero-survey of <i>Cryptococcus</i> antigenemia among HIV-infected adults with advanced immunosuppression in Namibia, 2013–14.
<p>Select demographic and clinical characteristics of sampled patients, sero-survey of <i>Cryptococcus</i> antigenemia among HIV-infected adults with advanced immunosuppression in Namibia, 2013–14.</p
Estimated Prevalence of <i>Cryptococcus</i> Antigenemia (CrAg) among HIV-Infected Adults with Advanced Immunosuppression in Namibia Justifies Routine Screening and Preemptive Treatment
<div><p>Background</p><p>Cryptococcal meningitis is common and associated with high mortality among HIV infected persons. The World Health Organization recommends that routine Cryptococcal antigen (CrAg) screening in ART-naïve adults with a CD4<sup>+</sup> count <100 cells/μL followed by pre-emptive antifungal therapy for CrAg-positive patients be considered where CrAg prevalence is ≥3%. The prevalence of CrAg among HIV adults in Namibia is unknown. We estimated CrAg prevalence among HIV-infected adults receiving care in Namibia for the purpose of informing routine screening strategies.</p><p>Methods</p><p>The study design was cross-sectional. De-identified plasma specimens collected for routine CD4<sup>+</sup> testing from HIV-infected adults enrolled in HIV care at 181 public health facilities from November 2013 to January 2014 were identified at the national reference laboratory. Remnant plasma from specimens with CD4<sup>+</sup> counts <200 cells/μL were sampled and tested for CrAg using the IMMY<sup>®</sup> Lateral Flow Assay. CrAg prevalence was estimated and assessed for associations with age, sex, and CD4<sup>+</sup> count.</p><p>Results</p><p>A total of 825 specimens were tested for CrAg. The median (IQR) age of patients from whom specimens were collected was 38 (32–46) years, 45.9% were female and 62.9% of the specimens had CD4 <100 cells/μL. CrAg prevalence was 3.3% overall and 3.9% and 2.3% among samples with CD4<sup>+</sup> counts of CD4<sup>+</sup><100 cells/μL and 100–200 cells/μL, respectively. CrAg positivity was significantly higher among patients with CD4+ cells/μL < 50 (7.2%, P = 0.001) relative to those with CD4 cells/μL 50–200 (2.2%).</p><p>Conclusion</p><p>This is the first study to estimate CrAg prevalence among HIV-infected patients in Namibia. CrAg prevalence of ≥3.0% among patients with CD4<sup>+</sup><100 cells/μL justifies routine CrAg screening and preemptive treatment among HIV-infected in Namibia in line with WHO recommendations. Patients with CD4<sup>+</sup><100 cells/μL have a significantly greater risk for CrAg positivity. Revised guidelines for ART in Namibia now recommend routine screening for CrAg.</p></div