التفاصيل البيبلوغرافية
| العنوان: |
Prevalence and predictors of Aspergillus seropositivity and chronic pulmonary aspergillosis in an urban tertiary hospital in Sierra Leone: A cross-sectional study. |
| المؤلفون: |
Lakoh, Sulaiman, Kamara, Joseph B., Orefuwa, Emma, Sesay, Daniel, Jiba, Darlinda F., Adekanmbi, Olukemi, Deen, Gibrilla F., Russell, James B. W., Bah, Abubakarr Bailor, Kargbo, Maxwell Joseph, Firima, Emmanuel, Yendewa, George A., Denning, David W. |
| المصدر: |
PLoS Neglected Tropical Diseases; 7/17/2023, Vol. 17 Issue 7, p1-17, 17p |
| مصطلحات موضوعية: |
PULMONARY aspergillosis, URBAN hospitals, MEDICAL personnel, SEROCONVERSION, ASPERGILLUS, MYCOSES |
| مصطلحات جغرافية: |
FREETOWN (Sierra Leone), SIERRA Leone |
| الشركة/الكيان: |
WORLD Health Organization |
| مستخلص: |
Background: In the World Health Organization Global Tuberculosis (TB) Report 2022, 37% of pulmonary TB patients were clinically diagnosed and thus many people were treated for TB without evidence of the disease. Probably the most common TB misdiagnosis is chronic pulmonary aspergillosis (CPA). In this study, we aimed to assess the prevalence and predictors of Aspergillus seropositivity and CPA in patients with chronic respiratory symptoms in an urban tertiary hospital in Sierra Leone. Methodology/principal findings: We used a cross-sectional study design to recruit adults (≥18 years) from the Chest Clinic of Connaught Hospital, Freetown between November 2021 and July 2022. Aspergillus antibody was detected using LDBio Aspergillus IgM/IgG. Logistic regression was performed to assess the independent predictors of Aspergillus seropositivity and CPA. Of the 197 patients with chronic respiratory symptoms, 147 (74.6%) were male. Mean age was 47.1 ± 16.4 years. More than half (104, 52.8%) had been diagnosed with TB in the past, while 53 (26.9%) were on TB treatment at the time of recruitment. Fifty-two (26.4%) patients were HIV positive, 41 (20.8%) were seropositive for Aspergillus and 23 (11.6%) had CPA, 2 (3.8%) with current TB and 18 (17.3%) with past TB. Common radiologic abnormalities reported were localized fibrotic changes 62 (31.5%), consolidation 54 (27.4%), infiltrates 46 (23.4%), hilar adenopathy 40 (20.3%) and pleural effusion 35 (17.85) and thickening 23 (11.7%). Common symptoms were weight loss 144 (73.1%), cough 135 (68.5%), fever 117 (59.4%) and dyspnea 90 (45.7%). Current or past TB infection {aOR 3.52, 95% CI (1.46, 8.97); p = 0.005} was an independent predictor of Aspergillus seropositivity and CPA. Conclusions/significance: We report a high prevalence of Aspergillus antibody seropositivity and CPA, underscoring the need to integrate the prevention and management of pulmonary fungal infections with TB services and asthma care in order to reduce unnecessary morbidity and mortality. Author summary: Chronic pulmonary aspergillosis (CPA) is a common cause of chronic lung disease. It mimics tuberculosis (TB), and can occur during or after TB treatment, mainly in patients with lung cavities. Since nearly 40% of TB cases worldwide are undiagnosed microbiologically, CPA may be the most common cause of symptoms in patients treated for TB without a microbiological diagnosis. Understanding the burden of CPA using the Aspergillus antibody test is an important initial step in addressing this persistent and chronic neglected disease in low-resource settings and presents an opportunity for healthcare workers to acquire the skills needed to reduce unnecessary CPA-related mortality. This study assessed the prevalence of Aspergillus seropositivity and CPA and found that 20.8% of patients were positive for Aspergillus antibodies and 11.6% had CPA. Common symptoms were cough, weight loss, difficulty breathing and fever and TB was an independent predictor of Aspergillus seropositivity and CPA. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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