Healthcare providers' perspectives on factors influencing treatment choices for HIV-associated cryptococcal meningitis in Tanzania: a qualitative exploratory study in two regional referral hospitals.

Abstract

To explore healthcare providers' perspectives on factors influencing treatment selection for HIV-associated cryptococcal meningitis (CM) in Tanzania. A hospital-based qualitative exploratory study. Dodoma and Singida Regions, Tanzania. 17 medical doctors, nurses and pharmacists working in the medical wards were purposely selected based on their clinical experience in managing adult patients with HIV-associated CM. Treatment choices were influenced by four major themes: (1) guideline awareness and transition from outdated practices; (2) provider experience, confidence and perceived competency; (3) recurrent stock-outs of amphotericin B, flucytosine and essential electrolyte supplements; and (4) patient-level financial barriers affecting access to monitoring and supportive care. HIV-associated CM treatment is shaped by healthcare providers, drug availability and patient-related factors. Targeted efforts to strengthen guideline dissemination, ensure uninterrupted antifungal supply and build provider capacity for safe amphotericin B use are crucial for improving CM outcomes.