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|Title:||The impact of cryptococcal antigenaemia screening among patients attending King Dinuzulu Hospital||Authors:||Yohali, Missi Emilienne||Keywords:||Impact;Cryptococcal antigenaemia;Screening;Cryptococcus neoformans;Cryptococcus meningitis||Issue Date:||29-Sep-2022||Abstract:||
The goal of this study was to give a general overview of Cryptococcus as a
cryptococcosis causative agent. The morbidity, mortality and management of this
type of infection are discussed, as well as the collaboration between the diagnostic
laboratory service and the Department of Health.
The goal of this study was to see how cryptococcal antigenemia screening affected
patient care at KDH.
To determine whether screening for cryptococcus antigenemia leads to doctors
necessary follow-up investigations. To report how often positive serum cryptococcal
antigen screening results in cryptococcal meningitis treatment. To see if the current
CD4 antigenemia threshold of less than 100 cells/µl is suitable for our patient
Materials and Method
This study took samples from patients at King Dinuzulu Hospital in Durban,
eThekwini, KwaZulu-Natal, South Africa. The Laboratory Information System was
utilized to diagnose cryptococcal infections in patients’ serum, plasma, and
cerebrospinal fluid (CSF), as well as for normal patient management (Trakcare).
Clinicians gathered specimens from patients as part of standard clinical care and
forwarded them to the laboratory as data sources for this study. Cross-sectional,
descriptive, and quantitative research were conducted on these specimens.
The data that satisfied the inclusion criteria of the study were collected and analysed.
Assay of 724 CSF and serum/plasma cryptococcal antigen (CrAg) results, including
CSF culture results (n = 264) and CD4 counts (n = 446), were analysed for this
section of the study. The bulk of CD4 counts, 433 (97.1%), were < 100 cell/µl whereas
13 (2.9%) were > 100 cells/µL. The number of patients with a CD4 count who stuck to their treatment was 22 out of 62. Eighty-five CrAg positive findings were obtained,
with 62 receiving a CD4 count. There were 31 CrAg with a CD4 count of 0-49 cells/µL,
28 with a CD4 count of 50-99 cells/µL, one with a CD4 count of 100-149 cells/µL, one
with a CD4 count of 150-199 cells/µL, and one with a CD4 count of more than 200
cells/µL. A higher percentage of patients had a follow up appointment. There was a
higher proportion of patients who received a follow-up (10, 55.6%) than those who
did not (3, 6.8%) p ˂ 0.001. Furthermore, those who started treatment within seven
days had a higher proportion of patients without follow up (81.8 percent, n = 36) than
those who had a follow up (0 percent, n = 0).
In conclusion, there was no positive benefit of CrAg screening on HIV-positive
patients attending KDH, as stated in the study’s goal. In terms of the study’s goal and
objectives, the findings revealed that the majority of positive CrAg samples were nt
followed up on.
Dissertation submitted in partial compliance with the requirements for the Master's degree in Medical Laboratory and Clinical Sciences at the Durban University of Technology, Durban, South Africa, 2022.
|Appears in Collections:||Theses and dissertations (Health Sciences)|
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