Mapping evidence on cryptococcal antigen infection among HIV-infected persons in sub-Saharan Africa- A Scoping Review Protocol

Introduction Infections of the central nervous system are a considerable basis of mortality in people living with Human immunodeficiency virus (HIV), with progression to cryptococcal meningitis documented at around 15% of HIV-associated mortality globally, with nearly three-quarters occurring in the sub-Saharan Africa. Discoveries from previous studies preluded that mortality amid cryptococcal antigen (CrAg) positive persisted to be elevated than in CrAg negative persons. One feasible interpretation of this could be due to undiagnosed cryptococcus. Laboratory investigations towards prompt identification of cryptococcal disease prior to cryptococcal meningitis has progressed to point-of-care testing with high sensitivity and specificity as seen with the CrAg lateral flow assay screening to expedite treatment. The aim of the study is to map and translate evidence on CrAg infection among HIV-infected persons in sub-Saharan Africa (SSA). Methodology The proposed scoping review will be conducted using guidelines proposed by Arksey and O’Malley methodological framework and Levac et al advanced method. It will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews. A comprehensive literature search of studies published from the first relevant publication to 2022 will be conducted on multiple electronic databases. Additional sources (grey literature) will also be searched. The search strategy will be generated and implemented by the principal investigator with assistance from a subject specialist, and an information specialist. Two reviewers will screen eligible studies. The screening will be guided by an inclusion and exclusion criteria. The mixed method appraisal tool (MMAT) version 2018 will be used to appraise the quality of the empirical studies. Discussion The proposed scoping review will map and translate evidence on CrAg infection among HIV-infected persons in sub-Saharan Africa. Synthesising and sharing recent evidence in this area has potential to help guide future research and interventions aimed at improving the management of CrAg infection among HIV-infected persons in sub-Saharan Africa and other high HIV-burdened settings. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The author(s) received no specific funding for this work ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: University of Pretoria Faculty of Health Sciences Research Ethics Committee I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Not Applicable No datasets were generated or analysed during the current study. All relevant data from this study will be made available upon study completion.