Laboratory Diagnosis of Cryptococcal Meningitisin Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome Patients at Moi Teaching and Referral Hospital

Abstract

Cryptococcus meningitis is aserious fungal infectionin HIV patients. India ink is the most used method for rapid detection of Cryptococcus neoformansin CSF specimens. Use of CrAg for laboratory diagnosis of cryptococcus meningitis at M.T.R.H will help reduce mortality. It isimportant therefore to compare the sensitivity of India ink test and CrAgagainst fungal culture for Cryptococcus neoformans in HIV AIDS patients at M.T.R.H. The main objective of the study was to compare the sensitivity of India ink test and CrAg against fungal culture for Cryptococcus neoformans in HIV AIDs patients. The study revealed that CrAg had high sensitivity of 94% and high specificity of 100% compared to 44% sensitivity and 98% specificity of India ink. Level of patients missed for cryptococcus meningitis using India ink was found to be 55.5% compared to 5.6% patients missed by CrAg. Risk ratio of CrAg compared to India ink in this study was 2.12. At 95% confidence interval, the 2.12 estimate is statistically significant at confidence limits of 1.65 and 2.74. In the final analysis, it was found out that cryptococcus meningitis in this study accounted for 18% of defining illnesses in HIV/AIDS patients at M.T.R.H. patients missed for cryptococcosis in the study was higher (55.5%) in India ink compared to that of CrAg. Due to high sensitivity in this study, CrAg test was recommended that it should replace India ink test that was used routinely for diagnosis of cryptococcus meningitis in HIV/AIDS at M.T.R.H.