Cryptococcal meningitis among human immunodeficiency virus patients attending major hospitals in Kisumu, Western Kenya

Background: Cryptococcal meningitis has become the most common lethal opportunistic fungal infection in people with HIV and AIDS. Prompt treatment depends on awareness of the common symptoms. The purpose of this study was to identify factors associated with Cryptococcus meningitis in HIV infected patients in Kisumu District. Methods: This was a cross sectional study carried out in two private (Aga Khan and Port Florence Community) and two public (Nyanza Provincial General and Kisumu District) hospitals in Kisumu town. A questionnaire was administered to 202 consenting patients with cryptococcal meningitis or their caretakers from January 2006 to December 2007. The data was analyzed by cross tabulations, frequencies and percentages. Findings: A total of 202 patients from 4 hospitals in Kisumu town were included in the study, most of them aged between 26 47 yrs. Headache was the most common symptom followed by neck stiffness and fever. The mean number of days from the onset of symptoms to admission was 32 and treatment started approximately 3 days later. Mean duration of stay in the hospital was 12 days, and the overall mortality rate 23.4%. Among the causes of delay in seeking treatment was mainly self medication (58.9%), with over 70% being treated for malaria. Most of the drugs taken before admission were antimalarials (83.2%) and painkillers (75%). None of the patients knew about meningitis before diagnosis. Conclusion: There is need for community awareness on cryptococcal meningitis symptoms to encourage prompt seeking of treatment at hospitals for proper management.