{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T15:54:54Z","timestamp":1765295694788,"version":"3.46.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cryptococcal meningitis (CM) is a significant cause of morbidity and mortality in individuals with advanced HIV. Ethiopia, with a high HIV burden and significant socioeconomic challenges, has limited data on CM. Understanding clinical practices is crucial to identifying gaps and improving disease management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A survey was conducted among health care workers (HCWs), microbiologists, and pharmacists across 9 Ethiopian health facilities from July to November 2024. Eligibility required active involvement in HIV or CM care. Ethics approval and informed consent were secured. Three profession-specific questionnaires were used to assess knowledge of CM care and challenges. Data were analyzed in R, version 4.3.2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 311 participants were included: HCWs, n = 202; microbiologists, n = 65; and pharmacists, n = 44. Most participants, 188\/202 (93.1%) HCWs, 42\/44 (95.5%) pharmacists, and 54\/65 (83.1%) microbiologists, recognized the need for additional guideline training. Only 59\/202 (29%) HCWs reported that screening for cryptococcal antigenemia was always performed. Among antifungals, fluconazole was the most available, with 21\/44 (48%) pharmacists and 49\/202 (24%) HCWs reporting it as always in stock. Liposomal amphotericin B (L-Amb) was reported as available by only 7\/44 (16%) pharmacists and 44\/202 (22%) HCWs. The most significant barriers to guideline implementation were insufficient policy support and challenges in integrating guidelines into electronic health records, as reported by 152\/202 (75.2%) and 143\/202 (70.8%) HCWs, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There are substantial gaps in CM care, highlighting the importance of improving resource allocation, technical assistance, additional training, and financial support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf715","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T13:25:43Z","timestamp":1763731543000},"source":"Crossref","is-referenced-by-count":0,"title":["Assessment of Clinical Guideline Use in the Prevention, Diagnosis, and Treatment of Cryptococcal Meningitis Among Health Care Providers in Ethiopia"],"prefix":"10.1093","volume":"12","author":[{"given":"Blen M","family":"Gebresilassie","sequence":"first","affiliation":[{"name":"Amanuel Mental Specialized Hospital , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6006-3909","authenticated-orcid":false,"given":"Gerome B","family":"Vallejos","sequence":"additional","affiliation":[{"name":"Program in Neuroinfectious Diseases, Department of Neurology, Columbia University Irving Medical Center, New York Presbyterian Hospital , New York, New York ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan S","family":"Walker","sequence":"additional","affiliation":[{"name":"Program in Neuroinfectious Diseases, Department of Neurology, Columbia University Irving Medical Center, New York Presbyterian Hospital , New York, New York ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8324-1868","authenticated-orcid":false,"given":"Omosefe","family":"Noruwa","sequence":"additional","affiliation":[{"name":"Program in Neuroinfectious Diseases, Department of Neurology, Columbia University Irving Medical Center, New York Presbyterian Hospital , New York, New York ,","place":["USA"]},{"name":"Harvard University , Cambridge, Massachusetts ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn B","family":"Holroyd","sequence":"additional","affiliation":[{"name":"Program in Neuroinfectious Diseases, Department of Neurology, Columbia University Irving Medical Center, New York Presbyterian Hospital , New York, New York ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Temesgen","family":"Nurye","sequence":"additional","affiliation":[{"name":"Program in Neuroinfectious Diseases, Department of Neurology, Columbia University Irving Medical Center, New York Presbyterian Hospital , New York, New York ,","place":["USA"]},{"name":"Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), San Francisco, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5714-7212","authenticated-orcid":false,"given":"Carla","family":"Kim","sequence":"additional","affiliation":[{"name":"Program in Neuroinfectious Diseases, Department of Neurology, Columbia University Irving Medical Center, New York Presbyterian Hospital , New York, New York ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7955-6030","authenticated-orcid":false,"given":"Biniyam","family":"Ayele","sequence":"additional","affiliation":[{"name":"Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), San Francisco, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiran T","family":"Thakur","sequence":"additional","affiliation":[{"name":"Program in Neuroinfectious Diseases, Department of Neurology, Columbia University Irving Medical Center, New York Presbyterian Hospital , New York, New York ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"key":"2025120910313666500_ofaf715-B1","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":"2025120910313666500_ofaf715-B2","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1097\/QAD.0b013e328322ffac","article-title":"Estimation of the current global burden of cryptococcal meningitis 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