Chronic Pulmonary Aspergillosis in Post Tuberculosis Patients in Indonesia and the Role of LDBio <i>Aspergillus</i> 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. <i>Aspergillus</i> IgG detection is the cornerstone of CPA diagnosis. There are a lack of studies o...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-11-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/6/4/318 |
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| author | Anna Rozaliyani Harmi Rosianawati Diah Handayani Heidy Agustin Jamal Zaini Ridhawati Syam Robiatul Adawiyah Mulyati Tugiran Findra Setianingrum Erlina Burhan Chris Kosmidis Retno Wahyuningsih |
| author_facet | Anna Rozaliyani Harmi Rosianawati Diah Handayani Heidy Agustin Jamal Zaini Ridhawati Syam Robiatul Adawiyah Mulyati Tugiran Findra Setianingrum Erlina Burhan Chris Kosmidis Retno Wahyuningsih |
| author_sort | Anna Rozaliyani |
| collection | DOAJ |
| description | 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. <i>Aspergillus</i> 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 <i>Aspergillus</i> 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 <i>Aspergillus</i> 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 (<i>p</i> < 0.001) with 80% sensitivity and 70% specificity. Logistic regression revealed a positive LDBio <i>Aspergillus</i> 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. |
| first_indexed | 2024-03-10T14:30:54Z |
| format | Article |
| id | doaj.art-35a72aca391b4a0cb38a978e3f35d22e |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-10T14:30:54Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-35a72aca391b4a0cb38a978e3f35d22e2023-11-20T22:33:57ZengMDPI AGJournal of Fungi2309-608X2020-11-016431810.3390/jof6040318Chronic Pulmonary Aspergillosis in Post Tuberculosis Patients in Indonesia and the Role of LDBio <i>Aspergillus</i> ICT as Part of the Diagnosis SchemeAnna Rozaliyani0Harmi Rosianawati1Diah Handayani2Heidy Agustin3Jamal Zaini4Ridhawati Syam5Robiatul Adawiyah6Mulyati Tugiran7Findra Setianingrum8Erlina Burhan9Chris Kosmidis10Retno Wahyuningsih11Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, IndonesiaPulmonary Mycosis Centre, Jakarta 10430, IndonesiaPulmonary Mycosis Centre, Jakarta 10430, IndonesiaPulmonary Mycosis Centre, Jakarta 10430, IndonesiaPulmonary Mycosis Centre, Jakarta 10430, IndonesiaDepartment of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, IndonesiaDepartment of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, IndonesiaDepartment of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, IndonesiaDepartment of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, IndonesiaPulmonary Mycosis Centre, Jakarta 10430, IndonesiaManchester Academic Health Science Centre, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M23 9LT, UKDepartment of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, IndonesiaChronic 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. <i>Aspergillus</i> 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 <i>Aspergillus</i> 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 <i>Aspergillus</i> 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 (<i>p</i> < 0.001) with 80% sensitivity and 70% specificity. Logistic regression revealed a positive LDBio <i>Aspergillus</i> 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.https://www.mdpi.com/2309-608X/6/4/318chronic pulmonary aspergillosistuberculosisIndonesia |
| spellingShingle | Anna Rozaliyani Harmi Rosianawati Diah Handayani Heidy Agustin Jamal Zaini Ridhawati Syam Robiatul Adawiyah Mulyati Tugiran Findra Setianingrum Erlina Burhan Chris Kosmidis Retno Wahyuningsih Chronic Pulmonary Aspergillosis in Post Tuberculosis Patients in Indonesia and the Role of LDBio <i>Aspergillus</i> ICT as Part of the Diagnosis Scheme Journal of Fungi chronic pulmonary aspergillosis tuberculosis Indonesia |
| title | Chronic Pulmonary Aspergillosis in Post Tuberculosis Patients in Indonesia and the Role of LDBio <i>Aspergillus</i> ICT as Part of the Diagnosis Scheme |
| title_full | Chronic Pulmonary Aspergillosis in Post Tuberculosis Patients in Indonesia and the Role of LDBio <i>Aspergillus</i> ICT as Part of the Diagnosis Scheme |
| title_fullStr | Chronic Pulmonary Aspergillosis in Post Tuberculosis Patients in Indonesia and the Role of LDBio <i>Aspergillus</i> ICT as Part of the Diagnosis Scheme |
| title_full_unstemmed | Chronic Pulmonary Aspergillosis in Post Tuberculosis Patients in Indonesia and the Role of LDBio <i>Aspergillus</i> ICT as Part of the Diagnosis Scheme |
| title_short | Chronic Pulmonary Aspergillosis in Post Tuberculosis Patients in Indonesia and the Role of LDBio <i>Aspergillus</i> ICT as Part of the Diagnosis Scheme |
| title_sort | chronic pulmonary aspergillosis in post tuberculosis patients in indonesia and the role of ldbio i aspergillus i ict as part of the diagnosis scheme |
| topic | chronic pulmonary aspergillosis tuberculosis Indonesia |
| url | https://www.mdpi.com/2309-608X/6/4/318 |
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