What is this article about?

This article describes the burden, clinical characteristics, treatment, and outcomes of cryptococcal disease among people living with HIV in three South African provinces, using GERMS-SA surveillance data. It highlights ongoing challenges related to advanced HIV disease and access to optimal treatment.

Why does this article matter?

Cryptococcal disease remains a major cause of illness and death among people with advanced HIV disease. This article provides updated data to identify gaps in HIV care and treatment access, which are critical to improving outcomes.

How did this article come about?

The study forms part of ongoing GERMS-SA surveillance work. There were no specific selection criteria for the provinces; instead, the analysis was structured into separate manuscripts to allow in-depth provincial reporting without direct comparison. This manuscript is the first in a series of three, with analyses of the remaining provinces to follow.

What was your role in the development of this article?  

I co-ordinated the study, oversaw data management and analysis, and led the drafting and revision of the manuscript in collaboration with co-authors and surveillance teams.

Why should people read this article?

It provides practical, real-world evidence on cryptococcal disease in South Africa and highlights opportunities to strengthen HIV care and reduce preventable deaths.

What impact do you hope this article will have on public health policy and healthcare access?

I hope the findings will support strengthened HIV programmes, improved access to early diagnosis and treatment, and more consistent availability of optimal antifungal therapy, including flucytosine, across all provinces.

Ms Tiisetso Lebaka is the Project Manager in the Division of Public Health Surveillance and Response at the National Institute for Communicable Diseases (NICD).

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