{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T09:47:54Z","timestamp":1782380874198,"version":"3.54.5"},"reference-count":17,"publisher":"Microbiology Society","issue":"6","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Makerere University Research and Innovation Grant","award":["MAKRIF1"],"award-info":[{"award-number":["MAKRIF1"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["D43TW010132"],"award-info":[{"award-number":["D43TW010132"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"crossref","award":["TMA2018CDF-2371"],"award-info":[{"award-number":["TMA2018CDF-2371"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,25]]},"abstract":"<jats:p>\n                    <jats:bold>Introduction:<\/jats:bold>\n                    Cryptococcal meningitis (CM) is a leading cause of mortality among people living with human immunodeficiency virus (HIV) in Sub-Saharan Africa, requiring rapid diagnosis. Although the Food and Drug Administration (FDA)-approved Dynamiker cryptococcal antigen lateral flow assay (CrAg LFA) offers a potential point-of-care solution, its use remains limited in high-burden settings.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Hypothesis\/Gap statement:<\/jats:bold>\n                    Despite FDA approval of Dynamiker CrAg LFA for the diagnosis of CM, the underutilization of the test in settings with a high burden of CM is of particular concern. Therefore, there is a need to validate its performance for the diagnosis of CM.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Aim:<\/jats:bold>\n                    To evaluate the diagnostic performance, turnaround time and cost-effectiveness of the Dynamiker CrAg LFA for CM, using cerebrospinal fluid (CSF) culture as the reference standard.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methodology:<\/jats:bold>\n                    Stored CSF samples from 200 HIV-positive patients with suspected or confirmed CM (\n                    <jats:italic>n<\/jats:italic>\n                    =245) were tested using the Dynamiker CrAg LFA. Diagnostic metrics were calculated and compared to CSF fungal culture. Time to result and average test cost were also assessed.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    The Dynamiker CrAg LFA showed a sensitivity of 100% and specificity of 84.9%, with strong agreement (\u03ba=0.83) with CSF culture. Median time to result was 30\u2009s compared to 3\u2009days for culture. The average cost per test was USD 3.41 versus USD 19.80\u201322.40 for CSF culture.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    The Dynamiker CrAg LFA is a rapid, accurate and affordable diagnostic tool for CM and holds promise for broader implementation in resource-limited settings.\n                  <\/jats:p>","DOI":"10.1099\/jmm.0.002173","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T09:15:42Z","timestamp":1782378942000},"source":"Crossref","is-referenced-by-count":0,"title":["The Dynamiker cryptococcal antigen lateral flow assay is an accurate, rapid and cost effective test comparable to culture for detection of cryptococcal meningitis"],"prefix":"10.1099","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6466-5780","authenticated-orcid":false,"given":"Maddy","family":"Nagwovuma","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5270-3539","authenticated-orcid":false,"given":"Richard","family":"Kwizera","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8854-0321","authenticated-orcid":false,"given":"David Bisagaya","family":"Meya","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9741-5429","authenticated-orcid":false,"given":"Beatrice","family":"Achan","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"345","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclepro.2023.139690"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0294940"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.2217\/fmb-2020-0006"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1177\/20499361241228345"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.2217\/bmm-2019-0333"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1080\/14737159.2024.2317414"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0011140"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1080\/14787210.2020.1785871"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1243"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00860-21"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(23)00731-4"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1590\/0037-8682-0307-2021"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.4314\/mmj.v32i1.2"},{"key":"R14","article-title":"Cost-effectiveness of reflex laboratory-based cryptococcal antigen screening for the prevention of cryptococcal meningtiis in Botswana the epidemiology, outcomes, and prevention of HIV-associated meningitis in Southern Africa","author":"Tenforde","year":"2019"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-017-2325-9"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.4314\/ajcem.v22i1.12"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02421-20"}],"container-title":["Journal of Medical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.microbiologyresearch.org\/content\/journal\/jmm\/10.1099\/jmm.0.002173?crawler=true&mimetype=application\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T09:15:43Z","timestamp":1782378943000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.microbiologyresearch.org\/content\/journal\/jmm\/10.1099\/jmm.0.002173"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6,25]]}},"URL":"https:\/\/doi.org\/10.1099\/jmm.0.002173","relation":{},"ISSN":["0022-2615","1473-5644"],"issn-type":[{"value":"0022-2615","type":"print"},{"value":"1473-5644","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]}}}