Cryptococcal Meningitis and Spatial Distribution of Pigeons (Columba livia) in Colombia (P4-8.004)

Abstract

<h3>Objective:</h3> To analyze the biogeographical distribution of <i>Columba livia</i> (Cl) in Colombia and its association with the density of meningeal cryptococcosis and HIV cases. <h3>Background:</h3> Cryptococcus spp. is widely distributed and the main cause of meningitis in HIV patients from low-income countries. Colombia exhibits a high prevalence of antigenemia and an above average incidence, while the most common (&gt;80%) clinical presentation of cryptococcosis in the country is meningitis. Exposure to pigeons feces has been stated as one of the risk factors and small studies from Colombia have found the fungus in 25% of these samples; nonetheless, it is still unknown if the geographical distribution of common pigeons (Cl) correlates with that of HIV and meningeal cryptococcosis. <h3>Design/Methods:</h3> Occurrences of Cl were extracted from the Global Biodiversity Information Facility and then mapped by municipalities. Information regarding HIV prevalence and mortality were provided by the Ministry of Health and cryptococcal meningitis prevalence was inferred from the passive laboratory-based surveillance system. Densities were calculated per 100 Km². Spearman correlation coefficients and robust linear regression were implemented. <h3>Results:</h3> In Colombia, 32226 occurrences of pigeons have been reported in 698 municipalities (55.25% of the country’s area). Median density of occurrence was 1.66 per 100 Km². Regarding the geographical distribution of HIV cases and fatalities, most were found in the highly populated departments. There was a moderate correlation of Cl occurrence distribution with HIV density by municipality (ρ=0.443, p=0.000) and cryptococcus cases at the departmental level (ρ=0.699, p=0.000). Significant association with occurrence persisted after adjusting by population density (β=0.603 CI 95% 0.258–0.949, p=0.001). <h3>Conclusions:</h3> There is evidence of geographical correlation between pigeons occurrence and density of cryptococcal meningitis. Further studies should address the impact of environmental variables on the fungus niche. <b>Disclosure:</b> Dr. Pinilla Monsalve has nothing to disclose. Miss Forero has nothing to disclose.