MORTALITY AFTER CLINICAL MANAGEMENT OF AIDS-ASSOCIATED CRYPTOCOCCAL MENINGITIS IN KENYA

Area of Science:

• Infectious Diseases
• Immunology
• Public Health

Background:

• Cryptococcal meningitis (CM) is a significant cause of death in HIV/AIDS patients in Africa.
• Identifying mortality predictors in CM patients can improve short-term prognosis and management.
• This study focuses on CM in Kenya, a region with high prevalence.

Purpose of the Study:

• To evaluate the clinical management of cryptococcal meningitis (CM) in HIV-positive patients in Kenya.
• To determine the mortality rates associated with CM in this patient population.
• To identify factors influencing survival and mortality in CM patients.

Main Methods:

• A retrospective study was conducted at Kenyatta National Hospital and Mbagathi District Hospital.
• Data was collected from 76 HIV-infected patients diagnosed with CM between August 2008 and March 2009.
• Clinical management and patient outcomes were analyzed to identify mortality predictors.

Main Results:

• Mortality rate for CM was 40% (30 out of 76 patients) during hospitalization.
• Predictors of mortality included TB co-infection, co-morbidities (diabetes, oral candidiasis, hypertension), and low CD4+ T lymphocyte counts.
• Male sex, prior or current ART, and CD4+ counts below 50 were significant in multivariable analysis. Survival was linked to at least two weeks of amphotericin B, ART initiation, and electrolyte monitoring.

Conclusions:

• Mortality associated with CM in Kenya remains high.
• There is a clear need to enhance clinical management strategies for hospitalized HIV-positive patients with CM.
• Improving treatment protocols and supportive care can lead to better short-term outcomes.