Factors associated with cryptococcal meningitis among people living with HIV infection in the Sumbawanga municipal council, Rukwa, Tanzania

Abstract

ABSTRACT Background: Despite the significant rate of mortality and morbidity caused by Cryptococcal meningitis among people living with HIV (PLHIV) in Tanzania. There are limited findings on the disease burden and associated factors among PLHIV. Understanding factors associated with cryptococcal meningitis such as immunological factors, knowledge, attitude, and perception among PLHIV is crucial for disease prevention and management strategies. This study assessed factors associated with cryptococcal meningitis among PLHIV in Sumbawanga Municipal Council where there is a high prevalence of HIV infection, and limited findings assessed the magnitude of diseases and related factors. Objectives: To assess factors associated with cryptococcal meningitis among people living with HIV infection in Sumbawanga Municipal Council, Rukwa, Tanzania. Methodology: This study was a cross-sectional survey employing quantitative data collection methods for 639 PLHIV attending nine health facilities in the Sumbawanga municipal council. The health facilities were selected using a multistage sampling technique. Descriptive statistics were used to summarise the data, including means, frequencies, and percentages. Inferential statistics such as chi-square or Fisher’s exact tests and logistic regression were used to analyze the strength of the association between the independent and dependent variables. An odd ratio with a P-value of ≤ 0.05 was considered statistically significant, and the confidence level will be 95%. Results: The prevalence of cryptococcal meningitis was 11/639(1.7%), with 20.9% occurring in participants with a CD4 count <200 and 4.8% with >1000 viral copies. Only 1.3% of participants demonstrated a high knowledge level, while the majority (68%) had a low level of knowledge. Additionally, over half (55%) have positive attitudes, and almost three-quarters (62%) have negative perceptions of cryptococcal meningitis. Duration on ART, Participant adherence, and CD4 count were statistically associated with those who tested positive for CrAg P-value ≤ 0.005 Conclusion: HIV implementing programs strengthen continuous education for PLHIV to increase awareness on cryptococcal meningitis, scale up CD4 testing, and enhance follow-up PLHIV with poor adherence, CD4 count <200, and naïve to ART as these factors are associated with cryptococcal meningitis.