Ambulatory induction phase treatment of cryptococcal meningitis in HIV integrated primary care clinics, Yangon, Myanmar.
BMC Infect Dis
; 21(1): 375, 2021 Apr 21.
Article
en En
| MEDLINE
| ID: mdl-33882845
ABSTRACT
BACKGROUND:
Cryptococcal meningitis (CM) is a common HIV-associated opportunistic-infection worldwide. Existing literature focusses on hospital-based outcomes of induction treatment. This paper reviews outpatient management in integrated primary care clinics in Yangon.METHOD:
This retrospective case note review analyses a Myanmar HIV-positive patient cohort managed using ambulatory induction-phase treatment with intravenous amphotericin-B-deoxycholate (0.7-1.0 mg/kg) and oral fluconazole (800 mg orally/day).RESULTS:
Seventy-six patients were diagnosed between 2010 and 2017. The median age of patients diagnosed was 35 years, 63% were male and 33 (45%) were on concurrent treatment for tuberculosis. The median CD4 count was 60 at the time of diagnosis. Amphotericin-B-deoxycholate infusions precipitated 56 episodes of toxicity, namely hypokalaemia, nephrotoxicity, anaemia, febrile reactions, phlebitis, observed in 44 patients (58%). One-year survival (86%) was higher than existing hospital-based treatment studies.CONCLUSION:
Ambulation of patients in this cohort saved 1029 hospital bed days and had better survival outcomes when compared to hospital-based studies in other resource constrained settings.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
10_ODS3_salud_sexual_reprodutiva
/
3_ND
Problema de salud:
10_sexually_transmitted_infections
/
3_neglected_diseases
/
3_tuberculosis
/
3_zoonosis
Asunto principal:
Atención Primaria de Salud
/
Fluconazol
/
Anfotericina B
/
VIH
/
Meningitis Criptocócica
/
Infecciones Oportunistas Relacionadas con el SIDA
/
Cryptococcus neoformans
/
Ácido Desoxicólico
/
Antifúngicos
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
BMC Infect Dis
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
Año:
2021
Tipo del documento:
Article
País de afiliación:
Myanmar