title: Feasibility and Acceptability of Cryptococcal Antigen Screening and Prevalence of Cryptocococcemia in Patients Attending a Resource-Limited HIV/AIDS Clinic in Malawi.
abstract: BACKGROUND
  The World Health Organization (WHO) recommends screening patients living with AIDS to detect and treat early cryptococcal infection.
  
  
  METHODS
  The authors evaluated a cryptococcal antigen (CrAg) screening and treatment program at an HIV/AIDS clinic in Malawi. Eligible patients were of age >18 years, had a CD4 count <100 cells/µL or WHO clinical HIV/AIDS stage III or IV.
  
  
  RESULTS
  Of 552 patients who presented for care, 113 were eligible, and all (100%) agreed to CrAg screening. Of them, 2 (1.8%; 95% confidence interval [CI]: 0-4.2%) patients were CrAg positive. Among those with CD4 count <100 cells/µL or WHO stage IV, the CrAg prevalence was 3.5% (95% CI: 0-8.4%) and 5.0% (95% CI: 0-15%), respectively.
  
  
  CONCLUSIONS
  A CrAg screening program was acceptable to new patients in a Malawian HIV/AIDS clinic. The CrAg prevalence for patients with CD4 count < 100 cells/µL and WHO stage IV was consistent with cost-effectiveness estimates. CrAg screening and treatment programs for patients living with AIDS should be expanded.
authors.affiliation: Partners in Hope Medical Centre, Lilongwe, Malawi.
authors.forename: Chifundo
authors.initials: C
authors.lastname: Chipungu
authors.affiliation: Division of Infectious Diseases, University of California Los Angeles, Los Angeles, USA jenniferanneveltman@gmail.com.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Veltman
authors.affiliation: Partners in Hope Medical Centre, Lilongwe, Malawi.
authors.forename: Perry
authors.initials: P
authors.lastname: Jansen
authors.affiliation: Partners in Hope Medical Centre, Lilongwe, Malawi.
authors.forename: Peter
authors.initials: P
authors.lastname: Chiliko
authors.affiliation: Partners in Hope Medical Centre, Lilongwe, Malawi.
authors.forename: Christina
authors.initials: C
authors.lastname: Lossa
authors.affiliation: Partners in Hope Medical Centre, Lilongwe, Malawi.
authors.forename: Dan
authors.initials: D
authors.lastname: Namarika
authors.affiliation: Partners in Hope Medical Centre, Lilongwe, Malawi.
authors.forename: Blake
authors.initials: B
authors.lastname: Benner
authors.affiliation: Fielding School of Public Health, University of California Los Angeles, Los Angeles, USA.
authors.forename: Risa M
authors.initials: RM
authors.lastname: Hoffman
authors.affiliation: Fielding School of Public Health, University of California Los Angeles, Los Angeles, USA.
authors.forename: Claire C
authors.initials: CC
authors.lastname: Bristow
authors.affiliation: Division of Infectious Diseases, University of California Los Angeles, Los Angeles, USA Fielding School of Public Health, University of California Los Angeles, Los Angeles, USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology*; D000328:Adult; D000554:Ambulatory Care Facilities; D000946:Antigens, Fungal / Q000097:blood*; D015331:Cohort Studies; D003453:Cryptococcosis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D042241:Early Diagnosis; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008295:Malawi / Q000453:epidemiology; D008297:Male; D008828:Microbiological Techniques / Q000191:economics / Q000379:methods; D009172:Mycology / Q000191:economics / Q000379:methods; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D055815:Young Adult
chemical_list: D000946:Antigens, Fungal
keywords: HIV/AIDS; asymptomatic cryptococcemia; cryptococcal meningitis; sub-Saharan Africa