Background: Cryptococcal meningitis (CM) is a leading cause of mortality among HIV-positive South Africans.Reflex cryptococcal antigen (CrAg) testing of remnant plasma was offered as a pilot prior to implementation in October 2016 in KwaZulu-Natal province.The national reflex CrAg positivity was 5.4% compared to 7.
3% for KwaZulu-Natal.Objectives: The aim of this study was to interrogate CrAg positivity by health levels to identify hotspots.Method: Data for the period October 2016 to June 2017 were analysed.Health district CrAg positivity and prevalence were calculated, with the latter using de-duplicated patient data.
The district CrAg positivity and the number craggy range sauvignon blanc 2022 of CrAg-positive specimens per health facility were mapped using ArcGIS.For districts with the highest CrAg positivity, a sub-district CrAg positivity analysis was conducted.Results: The provincial CrAg positivity was 7.6%.
District CrAg positivity ranged from 5.7% (Ugu) to 9.6% (Umkhanyakude) with prevalence ranging from 5.5% (Ugu) to 9.
7% (Umkhanyakude).The highest CrAg positivity was reported for the Umkhanyakude (9.6%) and cubs foam finger King Cetswayo (9.5%) districts.
In these two districts, CrAg positivity of 10% was noted in the Umhlabuyalingana (10.0%), Jozini (10.2%), uMhlathuze (10.5%) and Nkandla (10.
8%) subdistricts.In these subdistricts, 135 CrAg-positive samples were reported for the Ngwelezane hospital followed by 41 and 43 at the Hlabisa and Manguzi hospitals respectively.Conclusion: Cryptococcal antigen positivity was not uniformly distributed at either the district or sub-district levels, with identified facility hotspots in the Umkhanyakude and King Cetswayo districts.This study demonstrates the value of laboratory data to identify hotspots for planning programmatic interventions.