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Article History

Received: 3 June 2019

Accepted: 6 February 2020

First Online: 14 February 2020

Ethics approval and consent to participate

: Ethical approval was obtained from the Sierra Leone Ethics and Scientific Review Committee (SLESRC) of the Ministry of Health and Sanitation, Government of Sierra Leone. When patients had the capacity, informed written consent was approved by SLESRC was sought and obtained for completion of a questionnaire and examination. For all patients, the consent form was explained verbally in their local languages. Where patients were illiterate, the study and the consent form content were explained to them verbally and they indicated consent through a witnessed fingerprint as approved by SLESRC. Patients who declined consent were still eligible for CrAg testing, but their data was not included in the analysis.Some eligible participants lacked capacity as a result of suspected neurological opportunistic infections. The inclusion of this group was important in understanding the prevalence of cryptococcal infection in the study population. It was not felt ethical to seek consent from a representative as this would have involved the disclosure of HIV status; less than a third of people living with HIV in Sierra Leone have disclosed their status to adult relatives and levels of stigma are extremely high []. As study procedures posed minimal risk to participants, anonymised data from patients who were unable to consent were therefore also included. Consent was sought retrospectively from participants who regained capacity. All participants were free to withdraw at any time, and data were stored confidentially and anonymously.All study protocols (including waiver of consent from the next-of-kin and the procedure of consent from the patients that lacked the capacity) were approved by the SLERSC.

: Not applicable

: The authors declare that they have no competing interest.