Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS
Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS
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DOI：
10.1097/qad.0b013e328322ffac
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发表时间：
2009-02-20
期刊：
影响因子：
3.8
通讯作者：
Chiller, Tom A.
中科院分区：
文献类型：
--
作者：
Park, Benjamin J.;Wannemuehler, Kathleen A.;Chiller, Tom A.
目的：隐球菌性脑膜炎是最重要的HIV相关机会性感染之一，尤其是在发展中国家。为了帮助制定全球预防和治疗的战略和优先事项，重要的是要估计隐球菌脑膜炎的负担。设计：使用已发表的研究估计全球疾病负担。方法：我们使用地理区域内现有研究的发病率中位数来估计区域特异性隐球菌脑膜炎发病率;将其乘以2007年联合国艾滋病毒/艾滋病规划署对每个区域的艾滋病毒人口估计，以估计隐球菌脑膜炎病例。为了估计死亡，我们假设高收入地区的3个月病死率为9%，低收入和中等收入地区的病死率为55%，撒哈拉以南非洲的病死率为701%，这是基于这些地区发表的研究和专家意见。撒哈拉以南非洲的年负担估计值最高（中位发病率为3.2%，720 000例;范围为144 000- 130万）。西欧、中欧和大洋洲的中位发病率最低（
Objective: Cryptococcal meningitis is one of the most important HIV-related opportunistic infections, especially in the developing world. in order to help develop global strategies and priorities for prevention and treatment, it is important to estimate the burden of cryptococcal meningitis.Design: Global burden of disease estimation using published studies.Methods: We used the median incidence rate of available studies in a geographic region to estimate the region-specific cryptococcal meningitis incidence; this was multiplied by the 2007 United Nations Programme on HlV/AIDS HIV population estimate for each region to estimate cryptococcal meningitis cases. To estimate deaths, we assumed a 9% 3-month case-fatality rate among high-income regions, a 55% rate among low-income and middle-income regions, and a 701% rate in sub-Saharan Africa, based on studies published in these areas and expert opinion.Results: Published incidence ranged from 0.04 to 12% per year among persons with HIV. Sub-Saharan Africa had the highest yearly burden estimate (median incidence 3.2%, 720 000 cases; range, 144 000-1.3 million). Median incidence was lowest in Western and Central Europe and Oceania (