{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:04:41Z","timestamp":1789646681172,"version":"4.0.0"},"reference-count":36,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"unspecified","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,11]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore healthcare providers\u2019 perspectives on factors influencing treatment selection for HIV-associated cryptococcal meningitis (CM) in Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A hospital-based qualitative exploratory study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Dodoma and Singida Regions, Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>17 medical doctors, nurses and pharmacists working in the medical wards were purposely selected based on their clinical experience in managing adult patients with HIV-associated CM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Treatment choices were influenced by four major themes: (1) guideline awareness and transition from outdated practices; (2) provider experience, confidence and perceived competency; (3) recurrent stock-outs of amphotericin B, flucytosine and essential electrolyte supplements; and (4) patient-level financial barriers affecting access to monitoring and supportive care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HIV-associated CM treatment is shaped by healthcare providers, drug availability and patient-related factors. Targeted efforts to strengthen guideline dissemination, ensure uninterrupted antifungal supply and build provider capacity for safe amphotericin B use are crucial for improving CM outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-118749","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T11:45:34Z","timestamp":1789645534000},"page":"e118749","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Healthcare providers\u2019 perspectives on factors influencing treatment choices for HIV-associated cryptococcal meningitis in Tanzania: a qualitative exploratory study in two regional referral hospitals"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8963-4920","authenticated-orcid":false,"given":"Ritah Francis","family":"Mutagonda","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8660-7367","authenticated-orcid":false,"given":"Mlela","family":"Msongela","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"},{"name":"Department of Pharmacy, Singida Regional Referral Hospital, Singida, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline Victor","family":"Kinyonga","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Singida Regional Referral Hospital, Singida, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercy B","family":"Omary","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Dodoma Regional Referral Hospital, Dodoma, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George N","family":"Musiba","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"},{"name":"Department of Pharmacy, Muhimbili National Hospital, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5355-8353","authenticated-orcid":false,"given":"Manase","family":"Kilonzi","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"2026091704451356000_16.9.e118749.1","unstructured":"Pescador Ruschel MA , Thapa B . 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