Performance of LDBio Aspergillus WB and ICT Antibody Detection in Chronic Pulmonary Aspergillosis

Setianingrum, Findra; Azahra, Sresta; Abdullah, Asriyani; Fatril, Ayu Eka; Rosianawati, Harmi; Burhan, Erlina; Handayani, Dwi; Arifin, Arief Riadi; Zaini, Jamal; Tugiran, Mulyati; Adawiyah, Robiatul; Syam, Ridhawati; Kartika, Rona; Wahyuningsih, Retno; Kosmidis, Chris; Denning, David W.

doi:10.3390/jof7040311

Cited by 7 publications

(8 citation statements)

References 28 publications

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“…All of these tests have limitations including, false positives and false negatives [22,23]. In fact, evaluation studies and the clinical use evaluations of the LDBio Aspergillus-specific IgG and IgM assay employed in our study have reported varying sensitivities and specificities pooled at 90% and 91%, respectively, among different populations [6,8,[24][25][26][27][28]. Although, an elevated Aspergillus-specific IgG level is superior compared to other immunoglobulins in the diagnosis of CPA, it is possible for some CPA patients to have normal levels of Aspergillus-specific IgG but raised levels of Aspergillus-specific IgM, which may be positive in about half of the CPA patients [22].…”

Section: Discussionmentioning

confidence: 99%

Importance of Aspergillus-Specific Antibody Screening for Diagnosis of Chronic Pulmonary Aspergillosis after Tuberculosis Treatment: A Prospective Follow-Up Study in Ghana

Ocansey

Otoo

Gbadamosi

et al. 2022

JoF

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Chronic pulmonary aspergillosis (CPA) often occurs in patients that have been previously treated for pulmonary tuberculosis (PTB). A limited number of studies have looked at the development of CPA at different times following the completion of a PTB treatment course. This prospective longitudinal study aimed to determine the incidence of CPA at two timepoints, at the end of the PTB treatment (T1) and six months post-treatment (T2). Patients with confirmed PTB from a previous study who were placed on anti-TB medication were followed up and screened for CPA at T1 and T2 by assessing their symptoms, evaluating their quality of life, and screening them for Aspergillus infection by performing antibody testing and cultures. CPA was defined by the Global Action for Fungal Infections (GAFFI) diagnostic algorithm. Forty-one patients were enrolled, of whom thirty-three patients (80%) and twenty-eight patients (68%) were resurveyed at T1 and T2, respectively. The rate of new CPA was 3.3% (1/33) and 7.4% (2/27) at T1 and T2, respectively, with an overall incidence of 10.7% (3/28) among the patients at both T1 and T2. A positive Aspergillus-specific antibody test was an indicator for CPA in all three patients. Aspergillus-specific antibody screening during and after the end of an anti-TB treatment regimen may be important for early detection of CPA in high-PTB-burden settings.

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Section: Discussionmentioning

confidence: 99%

Importance of Aspergillus-Specific Antibody Screening for Diagnosis of Chronic Pulmonary Aspergillosis after Tuberculosis Treatment: A Prospective Follow-Up Study in Ghana

Ocansey

Otoo

Gbadamosi

et al. 2022

JoF

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“…A UK-based study confirmed the excellent sensitivity (92%) and specificity (98%), but also demonstrated that while sensitivity was optimal for the detection of disease caused by A. fumigatus (96%), the detection of non-fumigatus Aspergillus species remained acceptable (88%) and the LFA was also positive in 89% of cases where sputum culture was negative [33]. Lower specificities (72%) have been documented in some studies and in patients with bronchiectasis in the absence of aspergillosis (82%) [34,35]. Sensitivity of the LFA for the diagnosis of ABPA and severe asthma with fungal sensitization (SAFS) may be low (< 7%) [36].…”

Section: Lateral Flow Assaysmentioning

confidence: 93%

Developments in Fungal Serology

White

2023

Curr Fungal Infect Rep

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Purpose of Review The true incidence of fungal disease is hampered by conventionally poor diagnostic tests, limited access to advanced diagnostics, and limited surveillance. The availability of serological testing has been available for over two decades and generally underpins the modern diagnosis of the most common forms of fungal disease. This review will focus on technical developments of serological tests for the diagnosis of fungal disease, describing advances in clinical performance when available. Recent Findings Despite their longevity, technical, clinical, and performance limitations remain, and tests specific for fungal pathogens outside the main pathogens are lacking. The availability of LFA and automated systems, capable of running multiple different tests, represents significant developments, but clinical performance data is variable and limited. Summary Fungal serology has significantly advanced the diagnosis of the main fungal infections, with LFA availability increasing accessibility to testing. Combination testing has the potential to overcome performance limitations.

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“…The sample size was estimated considering a sensitivity of 85% and specificity of 84% (average of the diagnostic accuracies reported by Hunter et al 17 in healthy population and Rozaliyani et al 22 in tuberculosis-treated patients) and taking a precision of 8.5% with 95% confidence level. The sample size estimated was at least 68 cases and 72 non-CPA cases.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of LD BioAspergillus ICT Lateral flow assay for serodiagnosis of chronic pulmonary aspergillosis

Goel

Chowdhury

Sachdev

et al. 2022

Preprint

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Background: The diagnosis of CPA relies on the detection of IgG Aspergillus antibody which is not freely available, especially in resource-poor settings. Point-of-care tests like LDBio Aspergillus ICT lateral flow assay, evaluated in only a few studies, have shown promising results for diagnosis of CPA. However no study has compared the diagnostic performances of LDBio LFA in setting of tuberculosis endemic countries and have compared it with that of IgG Aspergillus. Objectives: This study aimed to evaluate the diagnostic performances of LDBio LFA in CPA and compare it with existing diagnostic algorithm utilising ImmunoCAP IgG Aspergillus. Methods: Serial patients presenting with respiratory symptoms (cough, hemoptysis, fever etc) for > 4 weeks were screened for eligibility. Relevant investigations including direct microscopy and culture of respiratory secretions, IgG Aspergillus, chest imaging etc were done according to existing algorithm. Serum of all patients were tested by LDBio LFA and IgG Aspergillus (ImmunoCAP Asp IgG) and their diagnostic performances were compared. Results: A total of 174 patients were included in the study with ~66.7% patients having past history of tuberculosis. A diagnosis of CPA was made in 74 (42.5%) of patients. The estimated sensitivity and specificity of LDBio LFA was 67.6% (95% CI: 55.7%- 78%) and 81% (95% CI: 71.9%-81%) respectively which increased to 73.3% (95% CI: 60.3%-83.9%) and 83.9% (95% CI: 71.7%-92.4%) respectively in patients with past history of tuberculosis. The sensitivity and specificity of IgG Aspergillus was 82.4% (95% CI: 71.8%-90.3%) and 82% (95% CI: 73.1-89%); 86.7% (95% CI: 75.4%-94.1%) and 80.4% (95% CI: 67.6%-89.8%) in the whole group and those with past history of tuberculosis respectively. Conclusions: LDBio LFA is a point-of-care test with reasonable sensitivity and specificity. However, further tests may have to be done to rule-in or rule-out the diagnosis of CPA in the appropriate setting.

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Performance of LDBio Aspergillus WB and ICT Antibody Detection in Chronic Pulmonary Aspergillosis

Cited by 7 publications

References 28 publications

Importance of Aspergillus-Specific Antibody Screening for Diagnosis of Chronic Pulmonary Aspergillosis after Tuberculosis Treatment: A Prospective Follow-Up Study in Ghana

Importance of Aspergillus-Specific Antibody Screening for Diagnosis of Chronic Pulmonary Aspergillosis after Tuberculosis Treatment: A Prospective Follow-Up Study in Ghana

Developments in Fungal Serology

Efficacy of LD BioAspergillus ICT Lateral flow assay for serodiagnosis of chronic pulmonary aspergillosis

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