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Scientists at the Kenya Medical Research Institute (Kemri) have started clinical trials of an oral drug that is deemed to be less toxic to the kidneys during the treatment of cryptococcus meningitis.

Cryptococcus neoformans Image/CDC
Cryptococcus neoformans

The research project seeks to find out if the test drug, Fluconazole, can replace Amphotericin B, an intravenous drug presently used as a routine treatment for meningitis despite concerns that it may be too toxic for the kidneys.

The trial drug is administered in hospital, with patients admitted for up to 14 days. In some cases, the treatment procedures involve draining spinal fluids daily to reduce pressure on the brain.

Fluconazole is considered as ‘fairly tolerable’ and flexible because patients can take it at home, without the need for hospitalisation. Kemri Associate Investigator Debra Lang’at said the 15 HIV-positive patients enrolled by the project were placed on a two-stage trial with 3 different drug regimens.

“We have not had any safety concerns. We are hopeful that the drug will be licensed to lessen the pain in patients while making it less expensive and more accessible,” Dr Lang’at said.

The study, which ran between 2010 and 2016, was done in Kenya, Uganda, South Africa and the United States. Cryptococcus meningitis is an infection that attacks the lining of the spinal cord and brain, especially among people with weakened immune systems or with immune disorders.

Symptoms include fever, fatigue, stiff neck, headache, nausea and vomiting, confusion, blurred vision and heightened sensitivity to bright lights. Kemri researchers are now screening all HIV-positive patients who present a CD4 count of less than 100 for meningitis.