Tackling cryptococcal meningitis in Nigeria, one-step at a time; the impact of training.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
    • Abstract:
      Background: Nigeria is estimated to have 25,000 cases of cryptococcal antigenemia (CrAg) annually. CrAg screening with pre-emptive fluconazole treatment is recommended but not yet implemented in Nigeria. Trainings were conducted to improve health-care provider (HCP) awareness and clinical skills in the management and prevention of cryptococcal meningitis (CM).
      Methods: HCPs providing care for people living with HIV were targeted for training at 13 sites from April to November 2018 Course content was adapted from CDC Cryptococcal Screening Program Training Manual and LIFE-website. "Hands-on" training on CrAg testing and lumbar puncture was included. A 14-point pre and post-test assessment instrument was designed to capture the impact of the training and focus group discussions (FGDs) were conducted.
      Results: A total of 761 HCPs were trained. 519 HCPs completed the pre-test evaluation while 470 (90.6%) took part in the post-test evaluation. Post-training, HCPs were significantly more likely to respond correctly to all 14 assessment items, with the mean percentage score rising to 91.0% from a pre-training value of 60.0%. FGDs revealed that many of the HCPs were not aware of the CrAg screening and pre-emptive treatment recommendations in Nigerian guidelines, and reported not having seen or managed a case of CM. Also, they highlighted challenges with routine CrAg screening due to a lack of access to CD4 testing, CrAg test kits, antifungal drugs, as well as the need for similar trainings across all tiers of care in Nigeria.
      Conclusion: Training significantly improved HCPs' understanding of Nigerian policy on CrAg screening, CM diagnosis and best management practices. This training could be included in routine capacity building efforts for HCPs involved in HIV care in Nigeria.
      Competing Interests: The authors have declared that no competing interests exist.
    • References:
      N Engl J Med. 2016 Feb 11;374(6):542-54. (PMID: 26863355)
      Saudi J Biol Sci. 2018 May;25(4):697-703. (PMID: 29740232)
      Clin Infect Dis. 2010 Aug 15;51(4):448-55. (PMID: 20597693)
      Curr Opin HIV AIDS. 2017 Mar;12(2):129-138. (PMID: 28059955)
      Niger J Med. 2010 Oct-Dec;19(4):395-9. (PMID: 21526627)
      Lancet Infect Dis. 2017 Aug;17(8):873-881. (PMID: 28483415)
      Curr Trop Med Rep. 2015;2(2):81-89. (PMID: 25960942)
      PLoS One. 2019 Jan 10;14(1):e0210105. (PMID: 30629619)
      PLoS One. 2016 Nov 9;11(11):e0165528. (PMID: 27829033)
      Clin Infect Dis. 2009 Sep 15;49(6):931-4. (PMID: 19681708)
      Clin Infect Dis. 2014 Dec 1;59(11):1607-14. (PMID: 25057102)
    • Publication Date:
      Date Created: 20200707 Date Completed: 20200914 Latest Revision: 20200914
    • Publication Date:
      20240105
    • Accession Number:
      PMC7337344
    • Accession Number:
      10.1371/journal.pone.0235577
    • Accession Number:
      32628714