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Cryptococcal meningoencephalitis: time for action

Stott, Katharine Elizabeth, Loyse, Angela, Jarvis, Joe N, Alufandika, Melanie, Harrison, Thomas Stephen, Mwandumba, Henry C, Day, Jeremy, Lalloo, David ORCID: https://orcid.org/0000-0001-7680-2200, Bicanic, Tihana, Perfect, John R and Hope, William (2021) 'Cryptococcal meningoencephalitis: time for action'. Lancet Infectious Diseases, Vol 21, Issue 9, pp. 259-271.

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Abstract

Cryptococcal meningoencephalitis was first described over a century ago. This fungal infection is preventable and treatable yet continues to be associated with excessive morbidity and mortality. The largest burden of disease resides in people living with HIV in low-income and middle-income countries. In this group, mortality with the best antifungal induction regimen (7 days of amphotericin B deoxycholate [1·0 mg/kg per day] and flucytosine [100·0 mg/kg per day]) in a clinical trial setting was 24% at 10 weeks. The world is now at an inflection point in terms of recognition, research, and action to address the burden of morbidity and mortality from cryptococcal meningoencephalitis. However, the scope of interventional programmes needs to increase, with particular attention to implementation science that is specific to individual countries. This Review summarises causes of excessive mortality, interventions with proven survival benefit, and gaps in knowledge and practice that contribute to the ongoing high death toll from cryptococcal meningoencephalitis. TRANSLATIONS: For the Vietnamese and Chichewa translations of the abstract see Supplementary Materials section.

Item Type: Article
Subjects: QW Microbiology and Immunology > Fungi. Pathogenic Fungi. > QW 180 Pathogenic Fungi
WL Nervous System > WL 300 General works (Include works on brain alone)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1016/S1473-3099(20)30771-4
Depositing User: Debbie Jenkins
Date Deposited: 27 May 2021 15:51
Last Modified: 03 Sep 2021 11:33
URI: https://archive.lstmed.ac.uk/id/eprint/17647

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