title: The prevalence, clinical features, risk factors and outcome associated with cryptococcal meningitis in HIV positive patients in Kenya.
abstract: OBJECTIVE
  To determine the prevalence, clinical features, risk factors and outcomes associated with cryptococcal meningitis (CM) in human immunodeficiency virus (HIV) positive patients at two referral hospitals in Nairobi, Kenya.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  Kenyatta National Hospital (KNH) and Mbagathi District Hospital (MDH), Nairobi, Kenya.
  
  
  METHODS
  Three hundred and forty HIV patients presenting with suspected CM.
  
  
  RESULTS
  Of three hundred and forty suspected CM patients, 111 (33%) were diagnosed with CM by CrAg. Among CM patients, in-hospital mortality was 36% (38/106), median age was 35 years (range, 19-60 years) and median CD4 count was 41 cells/microL (n = 89, range 2-720 cells/microL). Common clinical manifestations among CM patients included headache 103 (93%), neck stiffness 76 (69%) and weight loss 53 (48%). Factors independently associated with CM were male sex, headache, blurred vision and previous antifungal drug use. Night sweats and current use of anti-retroviral therapy were associated with reduced risk for CM.
  
  
  CONCLUSIONS
  There is a high prevalence of CM and CM-associated mortality in HIV patients at KNH and MDH despite treatment with antifungal and anti-retroviral drugs. This study demonstrates the need to address the existing inadequacies of CM patient outcomes in Kenya.
authors: University of Alabama, School of Public Health, 1665 University Boulevard, RPHB 217, Birmingham AL 35294-0022, USA.
authors: R
authors: R
authors: Mdodo
authors: K
authors: K
authors: Brown
authors: E
authors: E
authors: Omonge
authors: W
authors: W
authors: Jaoko
authors: J
authors: J
authors: Baddley
authors: P
authors: P
authors: Pappas
authors: M Colette
authors: MC
authors: Kempf
authors: I
authors: I
authors: Aban
authors: S
authors: S
authors: Odera
authors: A
authors: A
authors: Suleh
authors: P E
authors: PE
authors: Jolly
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D017052:Hospital Mortality; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D016919:Meningitis, Cryptococcal / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult