IJID regions最新文献

{"title":"Resurgence of cholera in Kosti City, Sudan: impact of armed conflict and water supply disruption","authors":"Ayman Azhary ,&nbsp;Nooh Mohamed Hajhamed ,&nbsp;Ahmed Noralla Altyip ,&nbsp;Elham Elamin ,&nbsp;Eman Taha Osman Ali ,&nbsp;Ayman Ahmed ,&nbsp;Emmanuel Edwar Siddig","doi":"10.1016/j.ijregi.2025.100700","DOIUrl":"10.1016/j.ijregi.2025.100700","url":null,"abstract":"<div><h3>Objectives</h3><div>This study assesses the magnitude and epidemiological characteristics of the recent cholera resurgence in Kosti City, Sudan, amid ongoing armed conflict and water supply disruptions.</div></div><div><h3>Methods</h3><div>This was a retrospective cross-sectional study based on hospital records that analyzed cholera surveillance data from Kosti Teaching Hospital from February 20, 2025, to February 24, 2025 (peak period). Epidemiological measures included case fatality rate (CFR) based on the following factors: age, sex, and displacement status. We analyzed the data using R software version 4.2.2.</div></div><div><h3>Results</h3><div>During the peak period, 1714 cholera cases and 69 fatalities were reported (CFR: 4.02%). 136 individuals were internally displaced, and age groups 1-4 and ≥65 years demonstrated the highest CFRs of 9.7% and 9.9%, respectively. By March 5, 2025, 1004 new cases had overwhelmed Kosti Teaching Hospital, with a lower fatality rate (2.3%) compared to the peak period’s CFR.</div></div><div><h3>Conclusions</h3><div>The resurgence of cholera in Kosti underscores the critical need for strengthened water, sanitation, and hygiene interventions and coordinated outbreak response strategies. Addressing underlying vulnerabilities is essential to prevent future outbreaks, especially in conflict-affected settings.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"16 ","pages":"Article 100700"},"PeriodicalIF":1.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine and human African trypanosomiasis in Angola: Local insights into challenges and opportunities for remote health delivery","authors":"Fernanda Gonçalves Ferreira Salvador ,&nbsp;Liliane de Fátima A. Oliveira ,&nbsp;Constantina Pereira Furtado Machado ,&nbsp;Pedro Mbueno Nzila ,&nbsp;Henrique Silveira ,&nbsp;Cláudia Maria Valete","doi":"10.1016/j.ijregi.2025.100696","DOIUrl":"10.1016/j.ijregi.2025.100696","url":null,"abstract":"<div><h3>Objectives</h3><div>Human African trypanosomiasis (HAT), or sleeping sickness, is a neglected tropical disease (NTD) endemic in rural Angola. Although telemedicine can improve healthcare access and coordination, its absence from HAT care highlights gaps in achieving World Health Organization goals for digital health equity and NTD control by 2030. To identify the challenges and opportunities for the local implementation of telemedicine in HAT care.</div></div><div><h3>Methods</h3><div>A mixed-methods study was conducted at the Instituto de Combate e Controlo das Tripanossomiases, a specialized unit of the Angolan Ministry of Health. One interview was conducted with the national HAT manager, and questionnaires were distributed to healthcare professionals, with a response rate of 61.5 %. This study was approved by the Ethics Committee of the Ministry of Health of Angola.</div></div><div><h3>Results</h3><div>Analysis revealed strong local interest in piloting telemedicine for HAT to improve healthcare access, particularly for remote case discussions among healthcare professionals in underserved areas. However, key barriers included unstable Internet connectivity, low digital literacy, insufficient human resources, and limited informatics support.</div></div><div><h3>Conclusions</h3><div>These challenges underscore the need for a multi-sectoral strategy to enable the integration of telemedicine into HAT care and advance digital health equity in Angola.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"16 ","pages":"Article 100696"},"PeriodicalIF":1.7,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, mortality rate, and factors associated with mortality in patients with sepsis in Vietnam","authors":"Luu Thi Thanh Duyen ,&nbsp;Nguyen Thanh Viet ,&nbsp;Ngo Thu Hang ,&nbsp;Nguyen Anh Tuan ,&nbsp;Le Van Khanh ,&nbsp;Tran Viet Tien ,&nbsp;Hoang Van Tong","doi":"10.1016/j.ijregi.2025.100695","DOIUrl":"10.1016/j.ijregi.2025.100695","url":null,"abstract":"<div><h3>Objectives</h3><div>The burden of sepsis in Vietnam remains largely undocumented. This study aims to estimate the prevalence and mortality rate of sepsis and to identify mortality-associated factors among patients with sepsis in a Vietnamese hospital.</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted to describe the clinical features, laboratory characteristics, and mortality rate of patients with sepsis. All patients admitted to intensive care units with culture-confirmed sepsis from October 2018 to December 2020 were included. Logistic regression and receiver operating characteristic analyses were conducted to identify mortality predictors.</div></div><div><h3>Results</h3><div>Of the 3890 enrolled patients, 2.7% (105 patients) had culture-confirmed sepsis, with 64% (67/105) classified as sepsis and 36% (38/105) as septic shock. The overall mortality rate was 52% (55 out of 105), with mortality rates of 42% (28 out of 67) for sepsis and 71% (27 out of 38) for septic shock. <em>Escherichia coli</em> (38%) was the most frequently isolated pathogen. Although resistance to carbapenems and third-generation cephalosporins was high, it was not associated with an increased risk of mortality. Logistic regression analysis identified neurologic dysfunction, comorbidities, blood lactate levels, and the number of acute organ dysfunctions as independent predictors of mortality in the overall cohort (area under the curve = 0.77). Among patients infected with <em>E. coli</em> or <em>Klebsiella pneumoniae</em>, hypertension, mechanical ventilation, and renal dysfunction were independently associated with mortality (area under the curve = 0.8).</div></div><div><h3>Conclusions</h3><div>Patients with sepsis in Vietnam exhibited a high mortality rate, with <em>E. coli</em> identified as the most common pathogen. Neurologic dysfunction was an independent predictor of mortality, whereas antibiotic resistance was not associated with higher mortality. The identified risk factors may help guide early clinical interventions to improve patient outcomes.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"16 ","pages":"Article 100695"},"PeriodicalIF":1.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the COVID-19 pandemic on other respiratory viruses in the Haut-Ogooué Province of Gabon","authors":"Christ-Emery Kombe Moulengui ,&nbsp;Jean-Bernard Lekana-Douki ,&nbsp;Sonia Etenna Lekana-Douki","doi":"10.1016/j.ijregi.2025.100699","DOIUrl":"10.1016/j.ijregi.2025.100699","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to assess the impact of the COVID-19 pandemic on the circulation, prevalence, and diversity of respiratory viruses other than SARS-CoV-2.</div></div><div><h3>Methods</h3><div>Between May 2020 and December 2021, 640 nasopharyngeal swabs were collected from individuals with or without respiratory symptoms, all of whom tested negative for SARS-CoV-2. Samples were analyzed for other respiratory viruses using real-time reverse transcription-polymerase chain reaction.</div></div><div><h3>Results</h3><div>The overall positivity rate for respiratory viruses was 4.37% (95% confidence interval: 2.79-5.96). Rhinovirus was the most common virus detected (1.25%), followed by PIV4 (0.78%), Human Coronavirus 229E (HCoV-229E) (0.62%), and influenza B (0.46%). Influenza A (H1N1pdm09) and Human Coronavirus OC43 (HCoV-OC43) each had a prevalence of 1%. Other viruses, including H3N2, Human Coronavirus NL63 (HCoV-NL63), and Human Coronavirus HKU1 (HCoV-HKU1), were less frequent (0.15%).</div></div><div><h3>Conclusions</h3><div>The study reveals a low circulation of respiratory viruses other than SARS-CoV-2 during the period from May 2020 to December 2021. This observation is directly linked to the preponderant circulation of SARS-CoV-2 and the strict measures put in place to limit its transmission.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"16 ","pages":"Article 100699"},"PeriodicalIF":1.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis: The insidious threat that compromises health in post-Assad Syria","authors":"Emir Muvaffak ,&nbsp;Salah Safadi ,&nbsp;Mohammad Al-Abbas ,&nbsp;Mazen Kherallah ,&nbsp;Abdulselam Daif ,&nbsp;Alfonso J. Rodriguez-Morales ,&nbsp;Josette Najjar ,&nbsp;Hazem Bakleh ,&nbsp;Mahmoud Karim ,&nbsp;Zaher Sahloul ,&nbsp;Aula Abbara","doi":"10.1016/j.ijregi.2025.100697","DOIUrl":"10.1016/j.ijregi.2025.100697","url":null,"abstract":"<div><div>This perspective explores the state of tuberculosis (TB) after the prolonged conflict in Syria and fall of the regime in December 2024; we discuss key considerations in light of multiple competing health priorities within Syria’s borders and the recovering health system. During the conflict, the health system fragmentation under differing geopolitical control led to unequal access to TB prevention, diagnostics and management social determinants such as poverty, malnutrition, inadequate water and sanitation, and lack of proper shelter, along with risks associated with disadvantaged groups, including internally displaced people, detainees, former detainees, and rural communities, not only increase the risk of TB transmission and the activation of latent infections but also hinder active case finding. Tackling these risks requires re-establishing the National TB Program (NTP) across the country, which acts equitably across all geographical areas to identify new cases, support robust surveillance activities, ensure drug resistance is identified promptly, and monitor treatment. Leadership from the Ministry of Health and the World Health Organization, with support from other stakeholders e.g., humanitarian, civil society or private sector can support the NTP and optimize health worker education and referral pathways. Beyond this, addressing the social determinants, which contribute to TB in Syria, is an essential component of TB control in post-conflict Syria.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"16 ","pages":"Article 100697"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors associated with infections linked to carbapenemase-producing Acinetobacter species circulating in the city of Yaoundé, Cameroon","authors":"Cedric Fossi Tchinda ,&nbsp;Karyom Djim-Adjim-Ngana ,&nbsp;Therence Annie Mbogning ,&nbsp;Brice Fredy Nemg Simo ,&nbsp;Sosthene Boido Baira ,&nbsp;Gaizirene Egoume Feudjieu ,&nbsp;Sonia Gayap Matchuenkam ,&nbsp;Gael Njini Nfor ,&nbsp;Guy Roussel Nguemto Takuissu ,&nbsp;Kikie Josiane Essola ,&nbsp;Connie Constance Georgina Walyaro ,&nbsp;Armelle Deutou Tchamgoue","doi":"10.1016/j.ijregi.2025.100698","DOIUrl":"10.1016/j.ijregi.2025.100698","url":null,"abstract":"<div><h3>Objectives</h3><div>Carbapenems are critical antibiotics used against multidrug-resistant infections, yet resistance is increasing, especially among Gram-negative bacteria like <em>Acinetobacter</em> species. In Cameroon, while <em>Acinetobacter baumannii</em> is well studied, little is known about other species such as <em>Acinetobacter pittii, Acinetobacter nosocomialis</em>, and <em>Acinetobacter calcoaceticus</em>. This study assessed the prevalence of carbapenemase-producing <em>Acinetobacter</em> and associated risk factors in Yaoundé hospitals.</div></div><div><h3>Methods</h3><div>A 6-month prospective cross-sectional study (April-September 2024) was conducted using 531 clinical samples from four health facilities. Strains were identified via morphologic, biochemical, and API 20 NE® tests. Antibiotic susceptibility was assessed using disc diffusion, and carbapenemases were characterized phenotypically.</div></div><div><h3>Results</h3><div>Of the samples, 4.9% yielded <em>Acinetobacter</em>, with <em>A. baumannii</em> being most common (80.8%), followed by <em>A. calcoaceticus</em> (11.5%) and <em>Acinetobacter anitratus</em> (7.7%). <em>A. baumannii</em> showed high antibiotic resistance, especially to beta-lactams, with 85.71% producing carbapenemases (83.33% class B and 16.67% class A). Significant risk factors included hospitalization, current antibiotic therapy, recent antibiotic use, and age group 38-47 years.</div></div><div><h3>Conclusions</h3><div>These findings highlight an urgent need for better surveillance, stricter antibiotic stewardship, and enhanced infection control strategies to limit the spread of resistant <em>Acinetobacter</em> infections in Yaoundé’s health care settings.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"16 ","pages":"Article 100698"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 pandemic reclassification and implications for continuing uptake of COVID-19 vaccination: The case of Savannah Region, Ghana, 2023","authors":"Michael Rockson Adjei ,&nbsp;Kwabena Adjei Sarfo ,&nbsp;Cyril Kwami Azornu ,&nbsp;Peter Gyamfi Kwarteng ,&nbsp;Felix Osei-Sarpong ,&nbsp;Janet Vanessa Baafi ,&nbsp;Nana Akua Afriyie Bafana ,&nbsp;Chrysantus Kubio ,&nbsp;Sally-Ann Ohene ,&nbsp;Martin Peter Grobusch","doi":"10.1016/j.ijregi.2025.100694","DOIUrl":"10.1016/j.ijregi.2025.100694","url":null,"abstract":"<div><h3>Objectives</h3><div>This study assessed the willingness of Ghanaians to accept COVID-19 vaccination following the pandemic reclassification. The findings are envisaged to facilitate implementation of contextual strategies to sustain the COVID-19 vaccination drive and avert case surges.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in three districts (North Gonja, Sawla-Tuna-Kalba, and West Gonja) of the Savannah Region using an electronic questionnaire to interview respondents on willingness to accept COVID-19 vaccinations following the pandemic reclassification. Bivariate and multivariate logistic regression analysis were performed to identify factors associated with continuing COVID-19 vaccination uptake.</div></div><div><h3>Results</h3><div>Respondents who would advocate for COVID-19 vaccination were more likely to accept it (adjusted odds ratio [AOR] = 8.4; 95% confidence interval [CI]: 6.18-11.41). Residing in an urban community (AOR = 0.78; 95% CI: 0.65-0.83) or having secondary education (AOR = 0.64; 95% CI: 0.46-0.89) was associated with reduced odds of COVID-19 vaccination acceptance.</div></div><div><h3>Conclusions</h3><div>The willingness to accept COVID-19 vaccination was high among the respondents, and the majority would encourage their neighbors to receive vaccination. However, targeted approaches are required to address vaccine hesitancy among specific subpopulations, including urban communities and those with secondary-level education.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"16 ","pages":"Article 100694"},"PeriodicalIF":1.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular characterization and antimicrobial resistance of Streptococcus pneumoniae isolated from adult patients with invasive pneumococcal disease in northern Japan, 2017-2023","authors":"Mitsuyo Kawaguchiya ,&nbsp;Meiji Soe Aung ,&nbsp;Noriko Urushibara ,&nbsp;Nobuhide Ohashi ,&nbsp;Nobuyuki Kobayashi ,&nbsp;Kenji Kudo ,&nbsp;Masahiko Ito ,&nbsp;Nobumichi Kobayashi","doi":"10.1016/j.ijregi.2025.100693","DOIUrl":"10.1016/j.ijregi.2025.100693","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to elucidate the molecular characteristics and antimicrobial resistance of <em>Streptococcus pneumoniae</em> isolates from adults with invasive pneumococcal disease (IPD) in the northern main island of Japan.</div></div><div><h3>Methods</h3><div>A total of 45 isolates obtained from adults (aged 41-98 years) with IPD between 2017 and 2023 were analyzed for serotype, sequence type (ST), and antimicrobial susceptibility.</div></div><div><h3>Results</h3><div>Of the 45 isolates, serotype 3-ST180 (24.4%) was the most prevalent, followed by 23A-ST338/ST5242 (13.3%); 23F-ST242/ST1437/ST3543 (8.9%); and 6D-ST282, 15A-ST63, 35B-ST558, and 34-ST1439/ST7388 (6.7% each), which collectively accounted for 73.4% of all isolates. The proportion of the pneumococcal conjugate vaccine (PCV) 13, PCV20, and 23-valent polysaccharide vaccine (PPSV23) serotypes were 44.5%, 46.7%, and 44.5%, respectively. The rate of non-susceptibility to penicillin was 24.4%, and the majority (n = 10 of 11, 90.9%) were also non-susceptible to erythromycin and tetracycline. The multidrug resistance rate for the non-PCV20/PPSV23 serotype was 83.3%, which was higher than the 71.4% for the vaccine serotypes. Among the non-PCV20/PPSV23 serotypes, 23A, 6D, 15A, 35B, and 6E (genetic variant of 6B) showed multidrug resistance with non-susceptibility to penicillin.</div></div><div><h3>Conclusions</h3><div>The present study revealed that the non-vaccine serotypes in IPD among adults were associated with a high prevalence of non-susceptibility to antimicrobial agents, suggesting the need for continuous surveillance.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"16 ","pages":"Article 100693"},"PeriodicalIF":1.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-tuberculous mycobacterial infections among patients with suspected or confirmed pulmonary tuberculosis in Ethiopia: A systematic review and meta-analysis","authors":"Deresse Daka ,&nbsp;Belay Tessema ,&nbsp;Awelani Mutshembele ,&nbsp;Amir Alelign ,&nbsp;Wubet Birhan ,&nbsp;Baye Gelaw","doi":"10.1016/j.ijregi.2025.100692","DOIUrl":"10.1016/j.ijregi.2025.100692","url":null,"abstract":"<div><h3>Objectives</h3><div>This study reviews and analyzes non-tuberculous mycobacteria (NTM) isolation from Ethiopian sputum samples, estimating prevalence, identifying common species, and analyzing regional and temporal variations.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis aimed to determine NTM prevalence among diseased individuals in Ethiopia. Using PubMed, Scopus, Web of Science, Google Scholar, and African Journals Online, we conducted a comprehensive literature search. Data extraction and quality assessment were conducted using the Newcastle–Ottawa scale. Meta-analysis was performed using STATA-18 software with a random-effects model and included subgroup analysis. The protocol of this study was registered with PROSPERO (CRD420251000131).</div></div><div><h3>Results</h3><div>In this review, a total of 5415 participants were involved, and 53.8% were patients with suspected tuberculosis (TB), 37.6% were patients with pulmonary TB, 4.0% were patients with multidrug-resistant TB, and 4.6% were HIV-positive patients. The NTM prevalence was 3.8%, showing high heterogeneity and regional species variability. The meta-analysis highlighted differences in NTM prevalence across age groups and diagnostic tools, emphasizing the need for enhanced diagnostics and continuous surveillance to improve patient outcomes and inform public health strategies.</div></div><div><h3>Conclusions</h3><div>The review summarizes the epidemiology and geographical distribution of NTM infections and common NTM species isolated from patients with suspected pulmonary TB in Ethiopia, revealing regional variations and clinical implications. Despite limited data, Ethiopia has a lower prevalence of NTM compared with other African regions and the worldwide average.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"16 ","pages":"Article 100692"},"PeriodicalIF":1.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of a 24-month study of patients with HIV with Cryptococcal meningitis on high-dose fluconazole induction in Abidjan, Côte d'Ivoire, between 2012 and 2016","authors":"Affoué Gisèle Kouakou ,&nbsp;Raoul Moh ,&nbsp;Frédéric Nogbou Ello ,&nbsp;Constant Ozigré ,&nbsp;Salif Diawara ,&nbsp;Hermann N’Guessan Faitey ,&nbsp;Serge Niangoran ,&nbsp;Alain N’douba Kassi ,&nbsp;Chrysostome Mossou ,&nbsp;Fulgence Kondo Kassi ,&nbsp;Aristophane Tanon ,&nbsp;Serge Paul Eholié","doi":"10.1016/j.ijregi.2025.100691","DOIUrl":"10.1016/j.ijregi.2025.100691","url":null,"abstract":"<div><h3>Objectives</h3><div>Cryptococcal meningitis (CM) is a common cause of meningitis in patients with AIDS in sub-Saharan Africa, with a mortality rate of over 50% at 10 weeks. The preferred treatment in resource-limited countries without access to amphotericin B or 5-fluorocytosine is high-dose fluconazole (FCZ). However, survival and factors associated with mortality after completion of FCZ-based treatment are not well known. To assess the outcomes at 24 months of patients with HIV with CM who have completed the initial FCZ treatment.</div></div><div><h3>Methods</h3><div>Retrospective cohort study of adult patients with HIV with CM on oral FCZ 1200 mg/day induction, having completed 10 weeks of specific treatment between January 2012 and December 2016. The survival probability (not lost to follow-up or death) at 24 months was determined and the risk factors associated with death were identified using the Cox proportional hazard model.</div></div><div><h3>Results</h3><div>Thirty-one (31) patients were enrolled from a total of 82. The median age was 42 years (38-44). Overall, 58% of the patients were female (n = 18) and 50% (14/28) were antiretroviral therapy experienced. The following outcomes were observed after 24 months of follow-up: 13 patients (41.9%) were lost to follow-up, 12 (38.7%) were still alive, 6 (19.3%) died, and 5 (16.1%) relapsed. The mortality rate was reduced by 77% where the clusters of differentiation 4 count was less than 100 cells/mm³, with adjustments for length of hospitalization and history of morbidities.</div></div><div><h3>Conclusions</h3><div>Long-term survival among patients with HIV with CM was poor. Interventions to strengthen linkage to HIV treatment and care and continuation of secondary fluconazole prophylaxis are critical.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"16 ","pages":"Article 100691"},"PeriodicalIF":1.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}