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.contributor.authorMissanga, Marco Thomas
dc.date.accessioned2020-03-05T09:42:42Z
dc.date.available2020-03-05T09:42:42Z
dc.date.issued2019
dc.descriptionDissertation (MMed Internal Medicine)en_US
dc.description.abstractBackground: 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.en_US
dc.identifier.citationMissanga, 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.en_US
dc.identifier.urihttp://hdl.handle.net/20.500.12661/2033
dc.language.isoenen_US
dc.publisherThe University of Dodomaen_US
dc.subjectCryptococcal meningitisen_US
dc.subjectCentral nervous systemen_US
dc.subjectHIV/AIDSen_US
dc.subjectHIV/AIDS patientsen_US
dc.subjectDodomaen_US
dc.subjectPoor managementen_US
dc.subjectIntracranial pressureen_US
dc.subjectIntravenous fluconazole monotherapyen_US
dc.subjectAcquired Immunodeficiency Syndromeen_US
dc.subjectHuman Immunodeficiency Virusen_US
dc.subjectMeningoencepahilitisen_US
dc.titleResponse of intravenous fluconazole monotherapy during the induction phase in the treatment of cryptococcal meningitis in HIV/AIDS adult patients in Dodoma, Tanzaniaen_US
dc.typeDissertationen_US
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