{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T13:24:22Z","timestamp":1773408262761,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,8,13]],"date-time":"2013-08-13T00:00:00Z","timestamp":1376352000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Ministry of Health and Social Welfare"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Cryptococcal antigen (<jats:styled-content style=\"fixed-case\">CRAG<\/jats:styled-content>) screening at antiretroviral therapy (<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>) initiation and pre\u2010emptive antifungal treatment for those testing positive could prevent many cases of cryptococcal meningitis (<jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content>). To investigate whether <jats:styled-content style=\"fixed-case\">CRAG<\/jats:styled-content> screening would be feasible in Tanzania, we conducted a cross\u2010sectional study measuring <jats:styled-content style=\"fixed-case\">CRAG<\/jats:styled-content> prevalence in <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> clinic patients and comparing the novel lateral flow assay (<jats:styled-content style=\"fixed-case\">LFA<\/jats:styled-content>) with the cryptococcal latex agglutination (<jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content>) test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected outpatients with <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 counts &lt;200 cells\/\u00b5L, who were <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> naive or had been on <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> for &lt;6\u00a0months, were screened for <jats:styled-content style=\"fixed-case\">CRAG<\/jats:styled-content> using the <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">LFA<\/jats:styled-content> kits. For further assay validation, <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected inpatients with suspected cryptococcal disease were also tested using the <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">LFA<\/jats:styled-content> kits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cryptococcal antigen was detected in seven of 218 <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> clinic attendees (3%). Six patients (5%) with <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 cell counts \u2264100\u00a0cells\/\u00b5L (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>124) were <jats:styled-content style=\"fixed-case\">CRAG<\/jats:styled-content>\u2010positive. Agreement between the <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">LFA<\/jats:styled-content> test in the 218 outpatients was 100%. Another 101 inpatients were tested for <jats:styled-content style=\"fixed-case\">CRAG<\/jats:styled-content>, of whom 56 (55%) were <jats:styled-content style=\"fixed-case\">CRAG<\/jats:styled-content>\u2010positive on both the <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">LFA<\/jats:styled-content> tests. One patient was positive using the <jats:styled-content style=\"fixed-case\">LFA<\/jats:styled-content> test but negative on the <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content> test. The overall agreement between the two assays was 99.7%, kappa coefficient 0.99 (standard error 0.06, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Five percentage of <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> clinic patients with <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 cell counts \u2264100\u00a0cells\/\u00b5L in northern Tanzania had asymptomatic cryptococcal antigenaemia, suggesting that <jats:styled-content style=\"fixed-case\">CRAG<\/jats:styled-content> screening would be worthwhile in the Tanzanian <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> programme. The <jats:styled-content style=\"fixed-case\">LFA<\/jats:styled-content> is a reliable, cheap and practical alternative to <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content> for detection of <jats:styled-content style=\"fixed-case\">CRAG<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12157","type":"journal-article","created":{"date-parts":[[2013,8,13]],"date-time":"2013-08-13T04:54:34Z","timestamp":1376369674000},"page":"1075-1079","source":"Crossref","is-referenced-by-count":43,"title":["Cryptococcal antigen prevalence in <scp>HIV<\/scp>\u2010infected Tanzanians: a cross\u2010sectional study and evaluation of a point\u2010of\u2010care lateral flow assay"],"prefix":"10.1111","volume":"18","author":[{"given":"Joan","family":"Rugemalila","sequence":"first","affiliation":[{"name":"Department of Medicine Kilimanjaro Christian Medical University College Moshi Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venance P.","family":"Maro","sequence":"additional","affiliation":[{"name":"Department of Medicine Kilimanjaro Christian Medical University College Moshi Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gibson","family":"Kapanda","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Kilimanjaro Christian Medical University College Moshi Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnold J.","family":"Ndaro","sequence":"additional","affiliation":[{"name":"Kilimanjaro Clinical Research Institute Biotechnology Laboratory Moshi Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph N.","family":"Jarvis","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Faculty of Infectious and Tropical Diseases London School of Hygiene and Tropical Medicine UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,8,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00446-12"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00732-12"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00536-12"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3282a4a64d"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1086\/597262"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/657405"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir613"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1545109712459077"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0069288"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-7-39"},{"key":"e_1_2_6_12_1","unstructured":"KwanCK LeelawiwatW IntalapapornPet\u00a0al. 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