Cryptococcal infection  causing  deaths in HIV infected cohorts is a major concern in resource limited settings.

Team@CMHF

The World Health Organization (WHO) has presented a new guidance document on the diagnosis, prevention and management of cryptococcal disease in HIV-infected adults, adolescents and children, with a focus on settings with limited health systems capacity and resources, and a high burden of the disease..
The WHO document, to be officially launched in March 2012, is entitled ‘Rapid Advice: Diagnosis, Prevention and Management of Cryptococcal Disease in HIV-Infected Adults, Adolescents and Children.’

Rapid Advice was first made public during a special session December 2011 16th International Conference on HIVAIDS and STIs taking place in Addis Ababa, Ethiopia.

The document outlines standards for high quality care of persons living with HIV infection and patients with cryptococcal disease, by providing evidence-based recommendations that consider the risks and benefits, acceptability, feasibility, cost and other resource implications.

Rapid Advice recommends six broad areas of intervention, including early diagnosis and treatment; prevention of the disease by initiating early antiretroviral therapy (ART), and the induction, consolidation and maintenance of treatment regimens.

Other broad action areas of intervention include adhering to a minimal package of toxicity prevention, monitoring and management of amphotericin B, and optimal timing of ART initiation or provider-initiated HIV testing and counseling and referral for HIV care services in order to facilitate early HIV diagnosis and uptake of ART.

The sixth broad general area of intervention is the discontinuation of treatment in adults and adolescents with successfully treated cryptococcal disease.  However, this recommendation also advises the continuation of treatment in children less than two years old.

In sub-Saharan alone, where more than 500,000 deaths each year due to crytptococcal meningitis, the commonest presentation of HIV-related cryptococcal disease is in adults.

Ref: http://www.afriquejet.com/cryptococcus-disease-2011120929214.html