Cryptococcal antigen carriage among HIV infected children aged 6 months to 15 years at Laquintinie Hospital in Douala

Cryptococcal antigen carriage among HIV infected children aged 6 months to 15 years at Laquintinie Hospital in Douala

Up to 15% of deaths of people living with HIV is attributable to meningeal cryptococcosis, with nearly 75% occuring in sub-Saharan Africa. Although rare in children, it is a major cause of morbidity and mortality in people living with HIV. A strong association between cryptococcal antigenemia and th...

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Published in:PloS one Vol. 16; no. 7; p. e0253781
Main Authors: Kalla, Ginette Claude Mireille, Mboumnyemb, Josette Farida, Assob, Jules Clément Nguedia, Ehouzou Mandeng, Marcelle Nina, Kamgaing Noubi, Nelly, Okomo Assoumou, Marie Claire, Mbopi-Keou, Francois-Xavier, Monebenimp, Francisca
Format: Journal Article
Language:English
Published: San Francisco Public Library of Science 09-07-2021
Public Library of Science (PLoS)
Subjects:
Acquired immune deficiency syndrome
Adolescents
Adults
AIDS
Analysis
Antifungal agents
Antigenemia
Antigens
Antiretroviral agents
Antiretroviral therapy
Biology and Life Sciences
CD4 antigen
Children
Cryptococcosis
Data analysis
Demographic variables
Diagnosis
Diseases
Flow cytometry
Fluconazole
Fungal infections
Health aspects
HIV
HIV infection
HIV patients
Human immunodeficiency virus
Immunosuppression
Infections
Infectious diseases
Laboratories
Mathematical analysis
Medicine
Medicine and Health Sciences
Meningitis
Morbidity
Mortality
Parasitology
Pediatrics
Teaching hospitals
Cameroon
Africa
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Summary:Up to 15% of deaths of people living with HIV is attributable to meningeal cryptococcosis, with nearly 75% occuring in sub-Saharan Africa. Although rare in children, it is a major cause of morbidity and mortality in people living with HIV. A strong association between cryptococcal antigenemia and the development of meningeal cryptococcosis has been shown in adults. Thus, in 2018, the World Health Organization published an updated version of its guidelines for the diagnosis, prevention and management of cryptococcal infection in adults, adolescents and the HIV-infected child. An analytical cross-sectional study was carried out at the approved treatment center of Laquintinie hospital in Douala over a period of 4 months. Children were recruited consecutively after informed parental consent. Cryptococcal antigenemia and CD4 assay were performed using a Cryptops.sup.® immunochromatographic rapid diagnostic test and flow cytometry, respectively. The data collected included the socio-demographic, clinical and paraclinical variables of the children, as well as their antecedents. Data analysis was performed using Epiinfo software version 3.1 and SPSS 21.0. The significance threshold was set at 5%. A total of 147 children were enrolled. The mean age was 9.8 ± 4.09 years. The majority were on antiretroviral therapy (142, 96.60%). Only 13 (8.80%) were in severe immunosuppression. No child showed signs of meningeal cryptococcosis. The prevalence of cryptococcal antigenemia was 6.12%. Severe immunosuppression [OR: 10.03 (1.52-65.91), p = 0.016] and contact with pigeons [OR: 9.76 (1.14-83.65), p = 0.037] were independent factors significantly associated with the carriage of the cryptococcal antigen. We recommend screening for cryptococcal antigenemia and routine treatment with fluconazole of all HIV positive children with cryptococcal antigen whether symptomatic or not.
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Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0253781