Chronic Pulmonary Aspergillosis in Post Tuberculosis Patients in Indonesia and the Role of LDBio Aspergillus ICT as Part of the Diagnosis Scheme

Chronic pulmonary aspergillosis (CPA) is a common sequela of pulmonary tuberculosis (TB). The diagnosis of CPA is difficult and often misdiagnosed as smear-negative TB in endemic settings. IgG detection is the cornerstone of CPA diagnosis. There are a lack of studies on the prevalence of CPA in Gene...

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Bibliographic Details
Published in:Journal of fungi (Basel) 2020-11, Vol.6 (4), p.318
Main Authors: Rozaliyani, Anna, Rosianawati, Harmi, Handayani, Diah, Agustin, Heidy, Zaini, Jamal, Syam, Ridhawati, Adawiyah, Robiatul, Tugiran, Mulyati, Setianingrum, Findra, Burhan, Erlina, Kosmidis, Chris, Wahyuningsih, Retno
Format: Article
Language:English
Subjects:
Anemia
Aspergillosis
Aspergillus
Blood tests
Cavitation
Chronic illnesses
Chronic obstructive pulmonary disease
chronic pulmonary aspergillosis
Diabetes
Diabetes mellitus
Diagnosis
Disease
HIV
Hospitals
Human immunodeficiency virus
Hypertension
Immunoglobulin G
Indonesia
Laboratories
Medical imaging
Patients
Risk factors
Tuberculosis
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Summary:Chronic pulmonary aspergillosis (CPA) is a common sequela of pulmonary tuberculosis (TB). The diagnosis of CPA is difficult and often misdiagnosed as smear-negative TB in endemic settings. IgG detection is the cornerstone of CPA diagnosis. There are a lack of studies on the prevalence of CPA in GeneXpert/smear-negative TB patients in Indonesia, despite a high number of TB cases. This study aims to determine the CPA rate in HIV-negative, GeneXpert-negative patients presenting with symptoms following completion of TB therapy and to evaluate the performance of LDBio immunochromatographic technology (ICT) lateral flow assay in the diagnosis of CPA. CPA was diagnosed on the basis of symptoms for ≥3 months, characteristic chest imaging and positive culture. Twenty (22%) out of 90 patients met the criteria for CPA. The LDBio test was positive in 16 (80%) CPA patients and in 21 (30%) non-CPA patients ( < 0.001) with 80% sensitivity and 70% specificity. Logistic regression revealed a positive LDBio ICT result, smoking history and diabetes to be important predictors of CPA diagnosis. Although CPA is an unrecognised disease in Indonesia, this study suggests that more than one in five GeneXpert negative patients with persistent symptoms following completion of TB therapy may have CPA.
ISSN:2309-608X
2309-608X
DOI:10.3390/jof6040318