Chronic pulmonary aspergillosis as a cause of smear-negative TB and/or TB treatment failure in Nigerians

Oladele, Rita O.; Irurhe, N.K.; Foden, Philip; Akanmu, Alani S; Gbajabiamila, Titilayo; Nwosu, Augustina O.; Ekundayo, Halimat Ayodele; Ogunsola, Folasade; Richardson, Malcolm; Denning, David W.

doi:10.5588/ijtld.17.0060

Cited by 70 publications

(127 citation statements)

References 7 publications

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“…This definition is consistent with the original definition of CPA proposed by Denning and colleagues [1]. Still, CPA is under-and mis-diagnosed in resource-constrained settings where adequate diagnostics are unavailable [6]. Previously treated PTB is the most common risk factor for the development of CPA even in the developed world [1].…”

supporting

confidence: 78%

“…The global burden of CPA attributed to healed TB lesions alone has been estimated to over 1.2 million cases annually globally [7]. On the other hand, active PTB is the number one differential diagnosis for CPA and CPA is the number one differential diagnosis for patients previously treated for microbiologically confirmed PTB who are currently sputum smear-negative [6]. Recent evidence has shown that the annual rate of new CPA development following completion of PTB treatment is about 6.5% in those with chest radiography cavitation and 0.2% in those without [8] (Fig.…”

mentioning

confidence: 99%

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Algorithm-aided diagnosis of chronic pulmonary aspergillosis in low- and middle-income countries by use of a lateral flow device

Kwizera

Katende

Teu

et al. 2019

Eur J Clin Microbiol Infect Dis

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supporting

confidence: 78%

mentioning

confidence: 99%

Algorithm-aided diagnosis of chronic pulmonary aspergillosis in low- and middle-income countries by use of a lateral flow device

Kwizera

Katende

Teu

et al. 2019

Eur J Clin Microbiol Infect Dis

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“…Several studies have recently been published with serological data using only commercial ELISA tests for CPA diagnosis in an area with high tuberculosis prevalence [1,12,37].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of serological tests for diagnosis of chronic pulmonary aspergillosis: A systematic review and meta-analysis

et al. 2020

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Chronic pulmonary aspergillosis (CPA) is a slow and progressive disease that develops in preexisting lung cavities of patients with tuberculosis sequelae, and it is associated with a high mortality rate. Serological tests such as double agar gel immunodiffusion test (DID) or counterimmunoelectrophoresis (CIE) test have been routinely used for CPA diagnosis in the absence of positive cultures. However, these tests have been replaced with enzyme-linked immunoassay (ELISA) and, a variety of methods. This systematic review compares ELISA accuracy to reference test (DID and/or CIE) accuracy in CPA diagnosis. It was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The study was registered in PROSPERO under the registration number CRD42016046057. We searched the electronic databases MEDLINE (PubMed), EMBASE (Elsevier), LILACS (VHL), Cochrane library, and ISI Web of Science. Gray literature was researched using Google Scholar and conference abstracts. We included articles with patients or serum samples from patients with CPA who underwent two serological tests: ELISA (index test) and IDD and/or CIE (reference test). We used the test accuracy as a result. Original articles were considered without a restriction of date or language. The pooled sensitivity, specificity, and summary receiver operating characteristic curves were estimated. We included 14 studies in the review, but only four were included in the meta-analysis. The pooled sensitivities and specificities were 0.93 and 0.97 for the ELISA test. These values were 0.64 and 0.99 for the reference test (DID and/or CIE). Analyses of summary receiver operating characteristic curves yielded 0.99 for ELISA and 0.99 for the reference test (DID and/or CIE). Our meta-analysis suggests that the diagnostic accuracy of ELISA is greater than the reference tests (DID and/or CIE) for early CPA detection.

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“…Several studies have recently been published with serological data using only commercial ELISA tests for CPA diagnosis in an area with a high prevalence of tuberculosis [1, 13, 36].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of serological tests for diagnosis of chronic pulmonary aspergillosis: a systematic review and meta-analysis

Chaves

Oliveira

Venturini

et al. 2019

Preprint

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22Chronic pulmonary aspergillosis (CPA) is a disease that benefits from cavities as after-effects of 23 tuberculosis, presenting a high mortality rate. Serological tests like double agar gel 24 immunodiffusion test (DID) or the counterimmunoelectrophoresis (CIE) test have been routinely 25 used for CPA diagnosis in the absence of positive cultures; however, they have been replaced by 26 enzyme-linked immunoassay (ELISA), with a variety of methods. 27 This systematic review aims to compare the accuracy of the ELISA test with the reference test 28 (DID and/or CIE) in CPA diagnosis. It was conducted according to the Preferred Reporting Items 29 for Systematic Reviews and Meta-Analyzes (PRISMA). 30 The study was registered in PROSPERO under the registration number CRD42016046057. We 31 searched the electronic databases MEDLINE (PubMed), EMBASE (Elsevier), LILACS (VHL), 32 Cochrane library, and ISI Web of Science. Gray literature was researched in Google Scholars and 33 conference abstracts. We included articles with patients or serum samples from CPA patients who 34 underwent two serological tests: ELISA (index test) and IDD and/or CIE (reference test), using 35 the accuracy of the tests as a result. Original articles were considered without a restriction of date 36 or language. The pooled sensitivity, specificity, and summary receiver operating characteristic 37 curves were estimated. 38 We included 13 studies in the review, but only four studies were included in the meta-analysis. 39 The pooled sensitivities and specificities were 0.93 and 0.97 for the ELISA test. For the reference 40 test (DID and/or CIE), these values were 0.64 and 0.99. Analyses of summary receiver operating 41 characteristic curves yielded 0.99 for ELISA and 0.99 for the reference test (DID and/or CIE). Our 46 Chronic pulmonary aspergillosis (CPA) is a slow and progressive lung disease caused by 47 Aspergillus spp. that develops in preexisting cavities of patients with chronic respiratory diseases, 48 and pulmonary tuberculosis is its main predisposing factor, with a global prevalence estimated at 49 1.2 million cases [1].I Its prognosis is poor, with 38-85% mortality in five years [1,2]. 50CPA presents five clinical forms: 1. aspergillus nodule, 2. pulmonary simple aspergilloma, 51 3. chronic cavitary pulmonary aspergillosis (CCPA), also called complex aspergilloma, 4. chronic 52 fibrosing pulmonary aspergillosis (CFPA), and 5. subacute invasive pulmonary aspergillosis 53 (SAIA) [3]. Aspergilloma is present in only one-third of patients with CPA [1,4]. 54The diagnosis of CPA is based on suggestive images, preferably tomographic images (CT 55 scan), on evidence of microbiological infection by Aspergillus or on the presence of an immune 56 response to this agent, maintained for at least 3 months [3,5]. 57Serologic tests are indispensable for the diagnosis in the absence of positive cultures and 58 are considered the best noninvasive tests to diagnose this entity [6,7]. These tests may be over 90% 59 positive with preci...

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Chronic pulmonary aspergillosis as a cause of smear-negative TB and/or TB treatment failure in Nigerians

Abstract: CPA is a neglected disease in Nigeria, and most cases match the World Health Organization diagnostic criteria for smear-negative TB.

Cited by 70 publications

References 7 publications

Algorithm-aided diagnosis of chronic pulmonary aspergillosis in low- and middle-income countries by use of a lateral flow device

Algorithm-aided diagnosis of chronic pulmonary aspergillosis in low- and middle-income countries by use of a lateral flow device

Accuracy of serological tests for diagnosis of chronic pulmonary aspergillosis: A systematic review and meta-analysis

Accuracy of serological tests for diagnosis of chronic pulmonary aspergillosis: a systematic review and meta-analysis

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