Tackling cryptococcal meningitis in Nigeria, one-step at a time; the impact of training
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 manageme...
Gespeichert in:
| Veröffentlicht in: | PloS one 2020-07, Vol.15 (7), p.e0235577-e0235577 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e0235577 |
|---|---|
| container_issue | 7 |
| container_start_page | e0235577 |
| container_title | PloS one |
| container_volume | 15 |
| creator | Oladele, Rita O Jordan, Alexander Akande, Patrick Akanmu, Sulaimon A Akase, Iorhen E Aliyu, Sani Denning, David W Chiller, Tom |
| description | 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). 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. 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. 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. |
| doi_str_mv | 10.1371/journal.pone.0235577 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_2420593765</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A628712522</galeid><doaj_id>oai_doaj_org_article_7514d7cec53046f8b9e84e61cea2b860</doaj_id><sourcerecordid>A628712522</sourcerecordid><originalsourceid>FETCH-LOGICAL-c669t-34da583c3097bcf283148c3c7ad3538fde660104abd2f346158a77cae22a303</originalsourceid><addsrcrecordid>eNqNkluL1DAUx4so7jr6DQQDgig4Y25NWgRhWbwMLC64iz6GM2naydg2NUnF_fZmZqpsZR8kDwknv_M_1yx7SvCKMEne7Nzoe2hXg-vNClOW51Ley05JyehSUMzu33qfZI9C2GGcs0KIh9kJo4IWkvDT7Ns16O-t7Ruk_c0QnXZaQ4s60yebjTYg26PPtjHewmuUQi1DNAOCiABF25m3KG4Nst0AOiJXo-jB7l0fZw9qaIN5Mt2L7OrD--vzT8uLy4_r87OLpRaijEvGK8gLphku5UbXtGCEF5ppCRVLydaVEQITzGFT0ZpxQfICpNRgKAWG2SJ7dlQdWhfU1JGgKKc4L5kUeSLWR6JysFODtx34G-XAqoPB-UaBj1a3Rsmc8Epqo3OGuaiLTWkKbgTRBuimEPto76Zo46YzlTZ9qradic5_ertVjfupJGOScZ4EXk4C3v0YTYiqs0GbtoXeuPGQNyGUMlYm9Pk_6N3VTVQDqQDb1y7F1XtRdXaYMM2T3CJb3UGlU5nO6jTT2ib7zOHVzCEx0fyKDYwhqPXVl_9nL7_O2Re32K2BNm6Da8doXR_mID-C2rsQvKn_Nplgtd_-P91Q--1X0_az3xPx9CE</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2420593765</pqid></control><display><type>article</type><title>Tackling cryptococcal meningitis in Nigeria, one-step at a time; the impact of training</title><source>Public Library of Science (PLoS) Journals Open Access</source><source>DOAJ Directory of Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Oladele, Rita O ; Jordan, Alexander ; Akande, Patrick ; Akanmu, Sulaimon A ; Akase, Iorhen E ; Aliyu, Sani ; Denning, David W ; Chiller, Tom</creator><contributor>Nielsen, Kirsten</contributor><creatorcontrib>Oladele, Rita O ; Jordan, Alexander ; Akande, Patrick ; Akanmu, Sulaimon A ; Akase, Iorhen E ; Aliyu, Sani ; Denning, David W ; Chiller, Tom ; Nielsen, Kirsten</creatorcontrib><description>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). 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. 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. 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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0235577</identifier><identifier>PMID: 32628714</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; AIDS ; Antifungal agents ; Antigenemia ; Best management practices ; Biology and Life Sciences ; Care and treatment ; CD4 antigen ; Complications and side effects ; Cryptococcal meningitis ; Curricula ; Diagnosis ; Disease control ; Disease prevention ; Evaluation ; Fluconazole ; Fungal infections ; Fungicides ; Health care ; Health screening ; Health services ; HIV ; HIV infections ; Human immunodeficiency virus ; Infectious diseases ; Medical diagnosis ; Medical laboratories ; Medical personnel training ; Medicine and Health Sciences ; Meningitis ; Mortality ; People and Places ; Prevention ; Public health ; Risk factors ; Training ; Websites</subject><ispartof>PloS one, 2020-07, Vol.15 (7), p.e0235577-e0235577</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c669t-34da583c3097bcf283148c3c7ad3538fde660104abd2f346158a77cae22a303</citedby><cites>FETCH-LOGICAL-c669t-34da583c3097bcf283148c3c7ad3538fde660104abd2f346158a77cae22a303</cites><orcidid>0000-0003-1488-3345 ; 0000-0002-4138-0594</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337344/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337344/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids></links><search><contributor>Nielsen, Kirsten</contributor><creatorcontrib>Oladele, Rita O</creatorcontrib><creatorcontrib>Jordan, Alexander</creatorcontrib><creatorcontrib>Akande, Patrick</creatorcontrib><creatorcontrib>Akanmu, Sulaimon A</creatorcontrib><creatorcontrib>Akase, Iorhen E</creatorcontrib><creatorcontrib>Aliyu, Sani</creatorcontrib><creatorcontrib>Denning, David W</creatorcontrib><creatorcontrib>Chiller, Tom</creatorcontrib><title>Tackling cryptococcal meningitis in Nigeria, one-step at a time; the impact of training</title><title>PloS one</title><description>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). 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. 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. 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.</description><subject>Acquired immune deficiency syndrome</subject><subject>AIDS</subject><subject>Antifungal agents</subject><subject>Antigenemia</subject><subject>Best management practices</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>CD4 antigen</subject><subject>Complications and side effects</subject><subject>Cryptococcal meningitis</subject><subject>Curricula</subject><subject>Diagnosis</subject><subject>Disease control</subject><subject>Disease prevention</subject><subject>Evaluation</subject><subject>Fluconazole</subject><subject>Fungal infections</subject><subject>Fungicides</subject><subject>Health care</subject><subject>Health screening</subject><subject>Health services</subject><subject>HIV</subject><subject>HIV infections</subject><subject>Human immunodeficiency virus</subject><subject>Infectious diseases</subject><subject>Medical diagnosis</subject><subject>Medical laboratories</subject><subject>Medical personnel training</subject><subject>Medicine and Health Sciences</subject><subject>Meningitis</subject><subject>Mortality</subject><subject>People and Places</subject><subject>Prevention</subject><subject>Public health</subject><subject>Risk factors</subject><subject>Training</subject><subject>Websites</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNkluL1DAUx4so7jr6DQQDgig4Y25NWgRhWbwMLC64iz6GM2naydg2NUnF_fZmZqpsZR8kDwknv_M_1yx7SvCKMEne7Nzoe2hXg-vNClOW51Ley05JyehSUMzu33qfZI9C2GGcs0KIh9kJo4IWkvDT7Ns16O-t7Ruk_c0QnXZaQ4s60yebjTYg26PPtjHewmuUQi1DNAOCiABF25m3KG4Nst0AOiJXo-jB7l0fZw9qaIN5Mt2L7OrD--vzT8uLy4_r87OLpRaijEvGK8gLphku5UbXtGCEF5ppCRVLydaVEQITzGFT0ZpxQfICpNRgKAWG2SJ7dlQdWhfU1JGgKKc4L5kUeSLWR6JysFODtx34G-XAqoPB-UaBj1a3Rsmc8Epqo3OGuaiLTWkKbgTRBuimEPto76Zo46YzlTZ9qradic5_ertVjfupJGOScZ4EXk4C3v0YTYiqs0GbtoXeuPGQNyGUMlYm9Pk_6N3VTVQDqQDb1y7F1XtRdXaYMM2T3CJb3UGlU5nO6jTT2ib7zOHVzCEx0fyKDYwhqPXVl_9nL7_O2Re32K2BNm6Da8doXR_mID-C2rsQvKn_Nplgtd_-P91Q--1X0_az3xPx9CE</recordid><startdate>20200706</startdate><enddate>20200706</enddate><creator>Oladele, Rita O</creator><creator>Jordan, Alexander</creator><creator>Akande, Patrick</creator><creator>Akanmu, Sulaimon A</creator><creator>Akase, Iorhen E</creator><creator>Aliyu, Sani</creator><creator>Denning, David W</creator><creator>Chiller, Tom</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-1488-3345</orcidid><orcidid>https://orcid.org/0000-0002-4138-0594</orcidid></search><sort><creationdate>20200706</creationdate><title>Tackling cryptococcal meningitis in Nigeria, one-step at a time; the impact of training</title><author>Oladele, Rita O ; Jordan, Alexander ; Akande, Patrick ; Akanmu, Sulaimon A ; Akase, Iorhen E ; Aliyu, Sani ; Denning, David W ; Chiller, Tom</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c669t-34da583c3097bcf283148c3c7ad3538fde660104abd2f346158a77cae22a303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>AIDS</topic><topic>Antifungal agents</topic><topic>Antigenemia</topic><topic>Best management practices</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>CD4 antigen</topic><topic>Complications and side effects</topic><topic>Cryptococcal meningitis</topic><topic>Curricula</topic><topic>Diagnosis</topic><topic>Disease control</topic><topic>Disease prevention</topic><topic>Evaluation</topic><topic>Fluconazole</topic><topic>Fungal infections</topic><topic>Fungicides</topic><topic>Health care</topic><topic>Health screening</topic><topic>Health services</topic><topic>HIV</topic><topic>HIV infections</topic><topic>Human immunodeficiency virus</topic><topic>Infectious diseases</topic><topic>Medical diagnosis</topic><topic>Medical laboratories</topic><topic>Medical personnel training</topic><topic>Medicine and Health Sciences</topic><topic>Meningitis</topic><topic>Mortality</topic><topic>People and Places</topic><topic>Prevention</topic><topic>Public health</topic><topic>Risk factors</topic><topic>Training</topic><topic>Websites</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Oladele, Rita O</creatorcontrib><creatorcontrib>Jordan, Alexander</creatorcontrib><creatorcontrib>Akande, Patrick</creatorcontrib><creatorcontrib>Akanmu, Sulaimon A</creatorcontrib><creatorcontrib>Akase, Iorhen E</creatorcontrib><creatorcontrib>Aliyu, Sani</creatorcontrib><creatorcontrib>Denning, David W</creatorcontrib><creatorcontrib>Chiller, Tom</creatorcontrib><collection>CrossRef</collection><collection>Opposing Viewpoints in Context (Gale)</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oladele, Rita O</au><au>Jordan, Alexander</au><au>Akande, Patrick</au><au>Akanmu, Sulaimon A</au><au>Akase, Iorhen E</au><au>Aliyu, Sani</au><au>Denning, David W</au><au>Chiller, Tom</au><au>Nielsen, Kirsten</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tackling cryptococcal meningitis in Nigeria, one-step at a time; the impact of training</atitle><jtitle>PloS one</jtitle><date>2020-07-06</date><risdate>2020</risdate><volume>15</volume><issue>7</issue><spage>e0235577</spage><epage>e0235577</epage><pages>e0235577-e0235577</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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). 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. 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. 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.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>32628714</pmid><doi>10.1371/journal.pone.0235577</doi><tpages>e0235577</tpages><orcidid>https://orcid.org/0000-0003-1488-3345</orcidid><orcidid>https://orcid.org/0000-0002-4138-0594</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2020-07, Vol.15 (7), p.e0235577-e0235577 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2420593765 |
| source | Public Library of Science (PLoS) Journals Open Access; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acquired immune deficiency syndrome AIDS Antifungal agents Antigenemia Best management practices Biology and Life Sciences Care and treatment CD4 antigen Complications and side effects Cryptococcal meningitis Curricula Diagnosis Disease control Disease prevention Evaluation Fluconazole Fungal infections Fungicides Health care Health screening Health services HIV HIV infections Human immunodeficiency virus Infectious diseases Medical diagnosis Medical laboratories Medical personnel training Medicine and Health Sciences Meningitis Mortality People and Places Prevention Public health Risk factors Training Websites |
| title | Tackling cryptococcal meningitis in Nigeria, one-step at a time; the impact of training |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-29T18%3A23%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Tackling%20cryptococcal%20meningitis%20in%20Nigeria,%20one-step%20at%20a%20time;%20the%20impact%20of%20training&rft.jtitle=PloS%20one&rft.au=Oladele,%20Rita%20O&rft.date=2020-07-06&rft.volume=15&rft.issue=7&rft.spage=e0235577&rft.epage=e0235577&rft.pages=e0235577-e0235577&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0235577&rft_dat=%3Cgale_plos_%3EA628712522%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2420593765&rft_id=info:pmid/32628714&rft_galeid=A628712522&rft_doaj_id=oai_doaj_org_article_7514d7cec53046f8b9e84e61cea2b860&rfr_iscdi=true |