Methods
Results
Conclusions
Background
Neurotoxoplasmosis: a 5-year story in the Dominican Republic
Describe HIV+ cases with neurotoxoplasmosis clinical presentation and common outcomes in the Dominican Republic (DR)
Despite breakthroughs in HIV testing and ART access, advanced HIV is still a Latin American health concern. The DR saw only a 4% reduction in HIV incidence rate during the last 5 years1. Suboptimal disease control and opportunistic infections like neurotoxoplasmosis may occur from a lack of specialized healthcare facilities, limited resources, and information availability in remote areas.
Retrospective case series study of individuals with HIV and neurotoxoplasmosis diagnosis from 2017 to 2022. Characteristics included demographics, clinical presentation, laboratory, and imaging. Quantitative data analyzed using dispersion and central tendency measures, whereas qualitative data analyzed using frequencies and percentages.
References:
1. UN AIDS, 10 Fast-Track commitments to end AIDS by 2030 [Internet]
median CD4 count
mean viral load
37 patients with HIV and neurotoxoplasmosis and a 37.8 [SD 9.55] years mean age; 70.2%[26] men.
Tuberculosis
CT scans showed hypodense lesions (72.4%[21]), mass effect (48.6%[18]), patchy white matter hypodensities (32.4%[12]), and vasogenic edema (27.02%[10]).
1 Research Department, Hospital General Plaza de la Salud.
2 Infectology Department, Hospital General Plaza de la Salud.
Most common neurological symptoms, %(n):
72.9% (27)
Headache
54.1% (20)
Hemiparesis
51.4% (19)
Seizures
Most common comorbidities, %(n):
Anemia
Myasthenia gravis
Hypertension
Most common coinfections, %(n):
29.7%
(11)
Oropharyngeal candidiasis
24 k/uL (IQR 53)
329.3 (SD 258)
29.7%
(11)
11.1%
(4)
8.1%
(3)
10.8%
(4)
Figure 1. MRI (TW2 Flair) of a 32yrs M; multifocal expansive process affecting the bilateral parietal lobes and right basal ganglia involving deep, periventricular and subcortical white substance with ring enhancing lesions.
Background
Results
Design/Methods
Objective
Conclusion
64% (24)
Without ART
10.8% (4)
Died within a year
Figure 2. MRI images of a 71yrs F; cortico-subcortical involutional changes, multifocal intra-axial expansive process, assessed neuroinfection. a) FLAIR, b) T2 FEE, c) T2W
Maria Cedeño-Bruzual1, Alana Agramonte1, Julio Rivas1, Génesis Chacón1, Rosa Medrano1, Angélica Montilla1, Ana Abreu-Guaba1, Ricardo Acra-Tolari1, Rita Rojas-Fermín2, Dolores Mejía1.
a)
b)
c)
Poster
Methods
Results
Conclusions
Neurotoxoplasmosis: a 5-year story in the Dominican Republic
Describe HIV+ cases with neurotoxoplasmosis clinical presentation and common outcomes in the Dominican Republic (DR)
Despite breakthroughs in HIV testing and ART access, advanced HIV is still a Latin American health concern. The DR saw only a 4% reduction in HIV incidence rate during the last 5 years1. Suboptimal disease control and opportunistic infections like neurotoxoplasmosis may occur from a lack of specialized healthcare facilities, limited resources, and information availability in remote areas.
Figure 3: Transition of ARV & Commodity Supplies Purchases by the Government of the Dominican Republic.
Source: U.S. President’s Emergency Plan for AIDS relief. Dominican Republic Country Operational Plan (COP/ROP) 2019 Strategic Direction Summary April 1, 2019 [Internet]. U.S. Governement; 2019 [cited 2023 Apr 18]. Available from: https://2017-2021.state.gov/wp-content/uploads/2019/09/Dominican-Republic_COP19-Strategic-Directional-Summary_public.pdf .
Poster
1 Research Department, Hospital General Plaza de la Salud.
2 Infectology Department, Hospital General Plaza de la Salud.
Objective
Background
Maria Cedeño-Bruzual1, Alana Agramonte1, Julio Rivas1, Génesis Chacón1, Rosa Medrano1, Angélica Montilla1, Ana Abreu-Guaba1, Ricardo Acra-Tolari1, Rita Rojas-Fermín2, Dolores Mejía1.
Background
Results
Conclusions
Background
Neurotoxoplasmosis: a 5-year story in the Dominican Republic
Quantitative data analyzed using dispersion and central tendency measures, whereas qualitative data analyzed using frequencies and percentages.
Poster
Maria Cedeño-Bruzual1, Alana Agramonte1, Julio Rivas1, Génesis Chacón1, Rosa Medrano1, Angélica Montilla1, Ana Abreu-Guaba1, Ricardo Acra-Tolari1, Rita Rojas-Fermín2, Dolores Mejía1.
1 Research Department, Hospital General Plaza de la Salud.
2 Infectology Department, Hospital General Plaza de la Salud.
Design/Methods
Retrospective
Case series study
2017-2022
Individuals with HIV and neurotoxoplasmosis
Demographics, clinical presentation, labs and imaging
Methods
Methods
Conclusions
Background
Neurotoxoplasmosis: a 5-year story in the Dominican Republic
median CD4 count
mean viral load
37 patients with HIV and neurotoxoplasmosis and a 37.8 [SD 9.55] years mean age; 70.2%[26] men.
Tuberculosis
Poster
CT scans showed hypodense lesions (72.4%[21]), mass effect (48.6%[18]), patchy white matter hypodensities (32.4%[12]), and vasogenic edema (27.02%[10]).
Most common neurological symptoms, %(n):
72.9% (27)
Headache
54.1% (20)
Hemiparesis
51.4% (19)
Seizures
Most common comorbidities, %(n):
Anemia
Myasthenia gravis
Hypertension
Most common coinfections, %(n):
29.7%
(11)
Oropharyngeal candidiasis
24 k/uL (IQR 53)
329.3 (SD 258)
29.7%
(11)
11.1%
(4)
8.1%
(3)
10.8%
(4)
Figure 1. MRI (TW2 Flair) of a 32yrs M; multifocal expansive process affecting the bilateral parietal lobes and right basal ganglia involving deep, periventricular and subcortical white substance with ring enhancing lesions.
Results
64% (24)
Without ART
10.8% (4)
Died within a year
Figure 2. MRI images of a 71yrs F; cortico-subcortical involutional changes, multifocal intra-axial expansive process, assessed neuroinfection. a) FLAIR, b) T2 FEE, c) T2W
a)
b)
c)
Maria Cedeño-Bruzual1, Alana Agramonte1, Julio Rivas1, Génesis Chacón1, Rosa Medrano1, Angélica Montilla1, Ana Abreu-Guaba1, Ricardo Acra-Tolari1, Rita Rojas-Fermín2, Dolores Mejía1.
1 Research Department, Hospital General Plaza de la Salud.
2 Infectology Department, Hospital General Plaza de la Salud.
Results
Methods
Results
Background
Neurotoxoplasmosis: a 5-year story in the Dominican Republic
Although recent advances in HIV management have been made, developing nations still face difficulties in accessing adequate care.
Maria Cedeño-Bruzual1, Alana Agramonte1, Julio Rivas1, Génesis Chacón1, Rosa Medrano1, Angélica Montilla1, Ana Abreu-Guaba1, Ricardo Acra-Tolari1, Rita Rojas-Fermín2, Dolores Mejía1.
1 Research Department, Hospital General Plaza de la Salud.
2 Infectology Department, Hospital General Plaza de la Salud.
Conclusion
HIV+ patients require continuous monitoring to avoid preventable conditions, such as neurotoxoplasmosis.
Poster
Conclusions
Methods
Results
Background
Neurotoxoplasmosis: a 5-year story in the Dominican Republic
Maria Cedeño-Bruzual1, Alana Agramonte1, Julio Rivas1, Génesis Chacón1, Rosa Medrano1, Angélica Montilla1, Ana Abreu-Guaba1, Ricardo Acra-Tolari1, Rita Rojas-Fermín2, Dolores Mejía1.
1 Research Department, Hospital General Plaza de la Salud.
2 Infectology Department, Hospital General Plaza de la Salud.
About the team
Poster
Conclusions
Part of the General Hospital Plaza de la Salud, an institution of national reference, our department is a component of the Knowledge and Innovation Management Center. We provide scientific and technological solutions to our country's major health-related problems.
Our top priorities are the generation of transformative knowledge, as well as guaranteeing and improving people's access to healthcare.