The Pan African Medical Journal (Dec 2020)

Epidemiological, clinical and biological profile of neuromeningeal cryptococcosis among people living with in Kinshasa, Democratic Republic of Congo

  • Bive Zono,
  • Erick Kamangu,
  • Hippolyte Situakibanza,
  • Evelyne Amaela,
  • Ben Bepouka,
  • Marcel Mbula,
  • Jean-Marie Kayembe,
  • Georges Mvumbi,
  • Marie-Pierre Hayette

DOI
https://doi.org/10.11604/pamj.2020.37.302.20521
Journal volume & issue
Vol. 37, no. 302

Abstract

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Neuromeningeal cryptococcosis (NMC) is one of the most frequent opportunistic infections (OI) in Human Immunodeficiency Virus (HIV) infection. In Kinshasa, the latest data on cryptococcosis were published in 1996. Objective: describe the epidemiological, clinical and biological profiles of NMC in HIV-infected people living in Kinshasa. This is a descriptive study based on the medical records of patients who attended three clinics in Kinshasa between January 1st 2011 and December 31st 2014. Only the medical records of HIV-infected people presenting the NMC were reviewed. During the 4 year-period of the study, 261 HIV-positive patients presented to the clinics for neuromeningeal syndrome, including 23 with NMC. The global prevalence of NMC was 8.8% for the three clinics. The mean age was 42.8 ± 9.5 years, with male predominance (65.2%). The main symptoms were headache (73.9%), neck stiffness (60.9%), fever (47.8%), and coma (47.8%). Biological records were as follows: median CD4 cell count was 79 cells/mm3 ; CerebroSpinal Fluid (CSF) was clear for 56.5% of the cases with predominance of neutrophils in 73.9%. The outcome was fatal in 34.8% of cases. The prevalence and therapeutic outcome of NMC show that it constitutes a non-negligible OI in Kinshasa, especially in HIV-infected people at the AIDS stage. As HIV-infected people with severe immunosuppression are the most affected by NMC, active preventive measures should benefit this vulnerable category of people.

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