{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T13:52:26Z","timestamp":1781272346966,"version":"3.54.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T00:00:00Z","timestamp":1689724800000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009900","name":"Busitema University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009900","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Mbale Clinical Research Institute"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cryptoccocal infection remains an important cause of morbidity and mortality among people with advanced human immunodeficiency virus disease (AHD). In resource-limited settings, there is a paucity of data on cryptoccocal infections. We described the prevalence and factors associated with cryptoccocal antigenemia among people with AHD in Mbale Regional Referral Hospital in Eastern Uganda.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this cross-sectional study, data on sociodemographic, clinical, and laboratory characteristics of adults with AHD were collected, and factors associated with cryptoccocal antigenemia were determined using multivariate logistic regression models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We enrolled 228 participants with a median CD4 cell count of 194\/\u00b5L (interquartile range, 129\u2013370\/\u00b5L). The prevalence of cryptoccocal antigen was 10 in 228 (4.4% [95% confidence interval, 2.4%\u201380%]). CD4 cell counts &amp;lt;100\/\u00b5L (adjusted odds ratio, 3.70) and poultry keeping were risk factors. The main predictors were headaches (adjusted odds ratio, 1), neck pains (8.817), confusion (6.323), and neck stiffness (676.217). No notable significant associations were found in the multivariate analysis<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The prevalence of cryptoccocal antigen was 4.4%, and antiretroviral therapy was protective.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofad351","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T23:48:54Z","timestamp":1689810534000},"source":"Crossref","is-referenced-by-count":6,"title":["Prevalence and Factors Associated With Cryptoccocal Antigenemia Among Patients With Advanced Human Immunodeficiency Virus in Eastern Uganda: A Facility-Based Cross-sectional Study"],"prefix":"10.1093","volume":"10","author":[{"given":"Ebonu","family":"Eric","sequence":"first","affiliation":[{"name":"Mbale Regional Referral Hospital, Department of Internal Medicine, Mbale city, Uganda"},{"name":"Busitema University Faculty of Health Sciences, Department of internal Medicine, Mbale city, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5757-609X","authenticated-orcid":false,"given":"Peter","family":"Olupot-Olupot","sequence":"additional","affiliation":[{"name":"Busitema University Faculty of Health Sciences, Department of internal Medicine, Mbale city, Uganda"},{"name":"Mbale Clinical Research Institute, Mbale city, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Bwayo","sequence":"additional","affiliation":[{"name":"Busitema University Faculty of Health Sciences, Department of internal Medicine, Mbale city, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Meya","sequence":"additional","affiliation":[{"name":"Makerere University College of Health Sciences, Department of Internal Medicine, Kampala city, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Katuramu","sequence":"additional","affiliation":[{"name":"Busitema University Faculty of Health Sciences, Department of internal Medicine, Mbale city, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,7,19]]},"reference":[{"key":"2023072709370561900_ofad351-B1","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1097\/00002030-200007070-00013","article-title":"Impact of HIV infection on meningitis in Harare, Zimbabwe: a prospective study of 406 predominantly adult patients","volume":"14","author":"Hakim","year":"2000","journal-title":"AIDS"},{"key":"2023072709370561900_ofad351-B2","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1016\/S1473-3099(17)30243-8","article-title":"Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis","volume":"17","author":"Rajasingham","year":"2017","journal-title":"Lancet Infect Dis"},{"key":"2023072709370561900_ofad351-B3","volume-title":"Harrison\u2019s principles of internal medicine","author":"Harrison","year":"2016"},{"key":"2023072709370561900_ofad351-B4","author":"World Health Organization","year":"2018"},{"key":"2023072709370561900_ofad351-B5","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1097\/QAD.0b013e328322ffac","article-title":"Estimation of the current global burden of cryptococcal meningitis among persons living with HIV\/AIDS","volume":"23","author":"Park","year":"2009","journal-title":"AIDS"},{"key":"2023072709370561900_ofad351-B6","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1097\/01.aids.0000174450.70874.30","article-title":"Incidence and risk factors of immune reconstitution inflammatory syndrome complicating HIV-associated cryptococcosis in France","volume":"19","author":"Lortholary","year":"2005","journal-title":"AIDS"},{"key":"2023072709370561900_ofad351-B7","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1086\/605500","article-title":"Cause-specific mortality and the contribution of immune reconstitution inflammatory syndrome in the first 3 years after antiretroviral therapy initiation in an urban African cohort","volume":"49","author":"Castelnuovo","year":"2009","journal-title":"Clin Infect Dis"},{"issue":"suppl 5","key":"2023072709370561900_ofad351-B8","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/myc.12387","article-title":"Cryptococcal disease burden and other fungal diseases in Uganda, where are the knowledge gaps and how can we fill them?","volume":"58","author":"Parkes Rantanshi","year":"2015","journal-title":"Mycoses"},{"key":"2023072709370561900_ofad351-B9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0051291","article-title":"Long-term 5-year survival of persons with cryptococcal meningitis or asymptomatic subclinical antigenemia in Uganda","volume":"7","author":"Butler","year":"2012","journal-title":"PLoS One"},{"key":"2023072709370561900_ofad351-B10","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1086\/587667","article-title":"Outcomes of cryptococcal meningitis in Uganda before and after the availability of highly active antiretroviral therapy","volume":"46","author":"Kambugu","year":"2008","journal-title":"Clin Infect Dis"},{"key":"2023072709370561900_ofad351-B11","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1086\/655143","article-title":"Cost-effectiveness of serum cryptococcal antigen screening to prevent deaths among HIV-infected persons with a CD4+ cell count \u2264100 cells\/\u03bcL who start HIV therapy in resource-limited settings","volume":"51","author":"Meya","year":"2010","journal-title":"Clin Infect Dis"},{"key":"2023072709370561900_ofad351-B12","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1086\/605497","article-title":"Cryptococcal immune reconstitution inflammatory syndrome after antiretroviral therapy in AIDS patients with cryptococcal meningitis: a prospective multicenter study","volume":"49","author":"Sungkanuparph","year":"2009","journal-title":"Clin Infect Dis"},{"key":"2023072709370561900_ofad351-B13","author":"Ministry of Health","year":"2020"},{"key":"2023072709370561900_ofad351-B14","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1186\/s12879-017-2325-9","article-title":"Cost-effectiveness of CRAG-LFA screening for cryptococcal meningitis among people living with HIV in Uganda","volume":"17","author":"Ramachandran","year":"2017","journal-title":"BMC Infect Dis"},{"key":"2023072709370561900_ofad351-B15","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1097\/QAI.0b013e31811ed32c","article-title":"Prevalence, determinants of positivity, and clinical utility of cryptococcal antigenemia in Cambodian HIV-infected patients","volume":"45","author":"Micol","year":"2007","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2023072709370561900_ofad351-B16","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1128\/CVI.00536-12","article-title":"Large-scale evaluation of the immuno-mycologics lateral flow and enzyme-linked immunoassays for detection of cryptococcal antigen in serum and cerebrospinal fluid","volume":"20","author":"Hansen","year":"2013","journal-title":"Clin Vaccine Immunol"},{"key":"2023072709370561900_ofad351-B17","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1758-2652-15-15","article-title":"Prevalence and factors associated with cryptococcal antigenemia among severely immunosuppressed HIV-infected adults in Uganda: a cross-sectional study","volume":"15","author":"Oyella","year":"2012","journal-title":"J Int AIDS Soc"},{"key":"2023072709370561900_ofad351-B18","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1590\/S0036-46652013000600001","article-title":"First report on Cryptococcus neoformans in pigeon excreta from public and residential locations in the metropolitan area of Cuiab\u00e1, State of Mato Grosso, Brazil","volume":"55","author":"Takahara","year":"2013","journal-title":"Rev Inst Med Trop Sao Paulo"},{"key":"2023072709370561900_ofad351-B19","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1086\/597262","article-title":"Screening for cryptococcal antigenemia in patients accessing an antiretroviral treatment program in South Africa","volume":"48","author":"Jarvis","year":"2009","journal-title":"Clin Infect Dis"},{"key":"2023072709370561900_ofad351-B20","article-title":"Detrimental outcomes of unmasking cryptococcal meningitis with recent ART initiation","volume":"5","author":"Rheins","year":"2018","journal-title":"Open Forum Infect Dis"},{"key":"2023072709370561900_ofad351-B21","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1097\/00002030-200205030-00009","article-title":"Cryptococcal infection in a cohort of HIV-1-infected Ugandan adults","volume":"16","author":"French","year":"2002","journal-title":"AIDS"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofad351\/50912111\/ofad351.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/10\/7\/ofad351\/50972750\/ofad351.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/10\/7\/ofad351\/50972750\/ofad351.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T09:38:28Z","timestamp":1690450708000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofad351\/7226501"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,1]]},"references-count":21,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofad351","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,7]]},"published":{"date-parts":[[2023,7,1]]},"article-number":"ofad351"}}