Response of intravenous fluconazole monotherapy during the induction phase in the treatment of cryptococcal meningitis in HIV/AIDS adult patients in Dodoma, Tanzania

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dc.creatorMissanga, Marco Thomas
dc.date2020-03-05T09:42:42Z
dc.date2020-03-05T09:42:42Z
dc.date2019
dc.date.accessioned2022-10-20T14:03:15Z
dc.date.available2022-10-20T14:03:15Z
dc.descriptionDissertation (MMed Internal Medicine)
dc.descriptionBackground: Cryptococcal Meningitis (CM) is the most common central nervous system (CNS) manifestation encountered in advanced HIV/AIDS patients. In low resource settings, it has high documented mortality rate at 2 and 10 weeks because of poor management of intracranial pressure (ICP), untimely ART initiation, and inappropriate antifungal regimen used during the induction phase. Objective: To evaluate the response of intravenous fluconazole monotherapy during the induction phase in the treatment of CM in HIV/AIDS adult patients in Dodoma. Methods: A prospective longitudinal study was conducted in DRRH in Dodoma City from November 2018 through May 2019. The confirmed HIV/AIDS adult patients with CM were enrolled into the study. Patient demographic and clinical data were collected using structured questionnaire. Blood and CSF samples were analysed at the time of enrolment and during the course of admission. At the end of the induction phase, clinical progress was evaluated along with repeat CSF analysis. Collected data were subsequently entered and analysed by SPSS version 23. Results: A total of 38 patients were enrolled into the study. Of these 24 (63.2%) were female and majority were ≥40 years old. Some clinical improvement was observed in 68.4% of the patients, 2 (5.6%) patients died, and 2 (5.6%) patients lost to follow up. Two thirds of the patients 22 (66.7%) were unable to sterilise the CSF at the end of the induction phase. Conclusion: Clinical improvement was observed in the majority of the patients, however there was poor response of intravenous fluconazole monotherapy during the induction phase in the treatment of CM in advanced HIV/AIDS patients.
dc.identifierMissanga, M. T. (2019). Response of intravenous fluconazole monotherapy during the induction phase in the treatment of cryptococcal meningitis in HIV/AIDS adult patients in Dodoma, Tanzania (Master's dissertation) The University of Dodoma, Dodoma.
dc.identifierhttp://hdl.handle.net/20.500.12661/2033
dc.identifier.urihttp://hdl.handle.net/20.500.12661/2033
dc.languageen
dc.publisherThe University of Dodoma
dc.subjectCryptococcal meningitis
dc.subjectCentral nervous system
dc.subjectHIV/AIDS
dc.subjectHIV/AIDS patients
dc.subjectDodoma
dc.subjectPoor management
dc.subjectIntracranial pressure
dc.subjectIntravenous fluconazole monotherapy
dc.subjectAcquired Immunodeficiency Syndrome
dc.subjectHuman Immunodeficiency Virus
dc.subjectMeningoencepahilitis
dc.titleResponse of intravenous fluconazole monotherapy during the induction phase in the treatment of cryptococcal meningitis in HIV/AIDS adult patients in Dodoma, Tanzania
dc.typeDissertation

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