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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
A comparison of cases of paediatric-onset and adult-onset cryptococcosis detected through population-based surveillance, 2005-2007
AIDS, Volume 26, No. 18, Year 2012
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Description
Objective: We compared the epidemiology of laboratory-confirmed paediatric cryptococcal disease with adult-onset disease in the South African population. Methods: The study was an active, prospective, population-based, laboratory-based surveillance in South Africa. We compared cases of paediatric cryptococcosis (<15 years) with cases of adult-onset cryptococcosis that were reported to the surveillance programme between 1 January 2005 and 31 December 2007. The case definition was based on a positive India ink test, cryptococcal antigen test or cryptococcal culture. Clinical case data were obtained at enhanced surveillance sites. Results: Of 16 192 incident episodes of cryptococcosis in South Africa, 361 (2%) episodes occurred among children. In 2007, incidence was one and 19 cases per 100 000 persons in the general paediatric and adult populations and was 47 and 120 cases per 100 000 persons for HIV-infected children and adults, respectively. Among children, a bimodal peak in incidence was evident in the less than 1-year age group and in the 5 age group. Most children (64%) and adults (63%) were severely immunocompromised (CD4 T-lymphocyte cell count < 50 cells/μl) at the time of diagnosis. On multivariable analysis, children were significantly more likely than adults to be male, diagnosed on blood culture, infected with Cryptococcus gattii, treated with amphotericin B and admitted for a longer stay in hospital. Conclusion: This series of 361 cases of paediatric cryptococcosis is by far the largest described to date. The diagnosis of cryptococcosis should be considered in the paediatric HIV-infected population, especially among those who are severely immunocompromised. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Authors & Co-Authors
Meiring, Susan T.
South Africa, Johannesburg
National Institute for Communicable Diseases
Quan, Vanessa Cecilia
South Africa, Johannesburg
National Institute for Communicable Diseases
Cohen, Cheryl D.
South Africa, Johannesburg
National Institute for Communicable Diseases
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
Dawood, Haiima
South Africa, Pietermaritzburg
Grey's Hospital Pietermaritzburg
Karstaedt, Alan S.
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
South Africa, Johannesburg
Chris Hani Baragwanath Hospital
McCarthy, Kerrigan M.
South Africa, Johannesburg
The Aurum Institute
Whitelaw, Andrew C.
South Africa, Cape Town
University of Cape Town
Govender, Nelesh P.
South Africa, Johannesburg
National Institute for Communicable Diseases
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
Statistics
Citations: 56
Authors: 8
Affiliations: 6
Identifiers
Doi:
10.1097/QAD.0b013e3283570567
e-ISSN:
14735571
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
South Africa
Participants Gender
Male