title: Cryptococcosis in Colombia: results of the national surveillance program for the years 2006-2010.
abstract: BACKGROUND
  A survey on cryptococcosis is being conducted regularly in Colombia since 1997. We present hereby the results corresponding to patients diagnosed from 2006 to 2010.
  
  
  OBJECTIVE
  To analyze the data obtained during this period.
  
  
  METHODS
  Retrospective analysis of the corresponding surveys.
  
  
  RESULTS
  A total of 526 surveys originating from 72% of the Colombian political divisions were received during the 5-year period. Most patients (76.6%) were males and 74.9% were 21-50 years old. The most prevalent risk factor was HIV infection (83.5%) with cryptococcosis defining AIDS in 23% of the cases. In the general population the estimated mean annual incidence rate for cryptococcosis was 2.4 x 106 inhabitants while in AIDS patients this rate rose to 3.3 x 103. In 474 surveys stating clinical features, most frequent complaints were headache 84.5%, fever 63.4%, nausea and vomiting 57.5%, mental alterations 46.3%, meningeal signs 33.0%, cough 26.4% and visual alterations 24.5%. Neurocryptococcosis was recorded in 81.8% of the cases. Laboratory diagnosis was based on direct examination, culture and latex in 29.3% cases. From 413 Cryptococcus isolates analyzed, 95.6% were identified as C. neoformans var. grubii, 1% C. neoformans var. neoformans, and 3.4% C. gattii. Treatment was reported for 71.6% of the cases with amphotericin B alone or in combination with fluconazole prescribed in 28%.
  
  
  CONCLUSIONS
  Surveys done through passive surveillance continue to be sentinel markers for HIV infection and represent a systematic approach to the study of opportunistic problems regularly afflicting AIDS patients since cryptococcosis requires no compulsory notification in Colombia.
authors.affiliation: Grupo de Microbiología, Instituto Nacional de Salud, Bogotá, D.C, Colombia. pescandon@ins.gov.co
authors.forename: Patricia
authors.initials: P
authors.lastname: Escandón
authors.forename: Catalina
authors.initials: C
authors.lastname: de Bedout
authors.forename: Jairo
authors.initials: J
authors.lastname: Lizarazo
authors.forename: Clara Inés
authors.initials: CI
authors.lastname: Agudelo
authors.forename: Angela
authors.initials: A
authors.lastname: Tobón
authors.forename: Solmara
authors.initials: S
authors.lastname: Bello
authors.forename: Angela
authors.initials: A
authors.lastname: Restrepo
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Castañeda
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D000946:Antigens, Fungal / Q000097:blood; D002648:Child; D003105:Colombia / Q000453:epidemiology; D003453:Cryptococcosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D056285:Cryptococcus gattii / Q000276:immunology / Q000302:isolation & purification; D003455:Cryptococcus neoformans / Q000276:immunology / Q000302:isolation & purification; D026141:Drug Resistance, Multiple, Fungal; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D063189:Symptom Assessment; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D000946:Antigens, Fungal; D000666:Amphotericin B; D015725:Fluconazole