Kenya slow in preventing meningitis deaths among HIV patients
Caused by Cryptococcus fungi, a fungus ubiquitous in nature, cryptococcal meningitis specifically attacks people with suppressed immune systems.
What you need to know:
- Caused by Cryptococcus fungi, a fungus ubiquitous in nature, cryptococcal meningitis specifically attacks people with suppressed immune systems. Symptoms include the classic symptoms of meningitis: fever, altered mental status and neck stiffness.
- People may also present with severe headache, nausea and vomiting, and vision difficulties.
Kenya has been listed as among Sub-Saharan countries that have been slow in adopting the World Health Organization (WHO) guidelines to ensure that people living with HIV survive cryptococcal meningitis, the second leading cause of AIDS-related deaths. The guidelines spread across five essential interventions for optimal diagnosis, treatment and prevention of the disease.
The HIV Policy Lab states that while Kenya is among three counties in East and Southern Africa that have adopted 11 out of 13 guidelines for cryptococcal meningitis and advanced HIV disease (AHD), it needs to fully adopt all the guidelines to address gaps that make the disease remain under-recognised, under-counted, under-diagnosed and under-treated.
WHO recommends CD4 testing to check the health of the immune system of a person infected with HIV so as to help determine when to initiate antiretroviral therapy.
However, only 14 Sub-Saharan African countries were found to be in alignment. In total, 31 countries had adopted testing guidelines only for HIV infected people entering – but not re-entering – HIV care.
Some Sub-Saharan African countries are also yet to adopt lumbar puncture procedure to confirm diagnosis of the disease and rapid tests for screening of cryptococcal meningitis. Pre-emptive and preventive treatment therapy has only been adopted by only 13 and 11 countries, respectively.
A recent report by the HIV Policy Lab states that cryptococcal meningitis is a major opportunistic infection in people living with HIV with CD4 counts below 200. This means that they have fewer cells that can help fight infections. Once infected with the fungus, they often develop meningitis, where the membrane surrounding the brain and spinal cord swells. In 2019, cryptococcal meningitis accounted for an estimated 103, 500 of the 690,000 HIV-related deaths,globally.
“Cryptococcal meningitis is the second largest killer of people living with HIV and is one of the most painful ways to die. It was responsible for an estimated 19 per cent of AIDS-related mortality and 112,000 deaths among people living with HIV in 2021,” says the report.
Caused by Cryptococcus fungi, a fungus ubiquitous in nature, cryptococcal meningitis specifically attacks people with suppressed immune systems. Symptoms include the classic symptoms of meningitis: fever, altered mental status and neck stiffness. People may also present with severe headache, nausea and vomiting, and vision difficulties.
“Cryptococcal meningitis among people living with HIV remains under-recognised, under-diagnosed and under-treated – resulting in a death rate estimated to be as high as 70 per cent in Africa compared to 20-30 per cent in high-income countries,” said Sharonann Lynch, co-director of the Center for Global Health Policy and Politics, which tracks HIV policies for 194 countries as part of its HIV Policy Lab.
With support from Drugs for Neglected Diseases initiative, the HIV Policy Lab launched an AHD (advanced HIV disease) Dashboard, which maps national guidelines for AHD and cryptococcal meningitis across 35 African countries.
“We hope our dashboard can serve to help monitor progress and encourage countries to fast-track full adoption of life-saving interventions against advanced HIV disease,” added Sharonann.
“Our goal is to reduce the time lag between the generation of scientific evidence and policy adoption by national health authorities.”
