Status of pulmonary fungal infections among individuals with clinical signs of pulmonary tuberculosis at a University Teaching Hospital in Southwestern Uganda.

Abstract

Background: Pulmonary mycoses are very important diseases of the respiratory tract and are responsible for significant morbidity and mortality rates worldwide. However less attention has been paid to them. In this study we determined the prevalence of pulmonary mycoses and their aetiological agents among individuals with clinical signs of pulmonary tuberculosis at Mbarara Regional Referral Hospital (MRRH). Method: This was a Laboratory based cross sectional survey in which 113 participants were recruited. Sputum samples were corrected from each study participant. To each sample the following tests were done; Sabouraud Dextrose Agar (SDA) Culture, GeneXpert and Potassium hydroxide (KOH). Fungal growth of filamentous fungi and yeasts were further examined with LPCB and Germ tube respectively. Generated data was analysed using R studio. Results: Out of 113 participants, 80 (70.8%) had pulmonary mycoses whilst those with pulmonary tuberculosis were 5 (4.4%). C. albicans 22.58% and Aspergillus species 17.20%) were the most aetiological agents for pulmonary mycoses identified among others. Of those who were TB GeneXpert positive, 2 (1.77%) of them were co-infected with pulmonary mycoses. We established a prevalence of 57 (71.3%) for PFI, 3 (60.0%) for MTB in HIV sero positive patients and 18 (22.5%) for PFI, 0 (0.00%) for MTB in HIV sero negative patients. On the other hand, 2 (100%) sero positive patients were co-infected with both PFI and MTB.Conclusion: Our findings highlight the medical importance of pulmonary fungal infections among patients suspected for TB. Importantly, the aetiological diversity established here is rich enough to suggest precise examination using different methods. Established scope of aetiological agents is predominated by opportunistic fungi which when superimposed on to certain underlying conditions such as TB, their effects can be fatal. Therefore this possibility presents a need to employ appropriate strategies for prevention, diagnosis, and management in TB suspects.

Prevalence of Pulmonary Aspergillosis and Drug Susceptibility Testing Amongst Adult Hiv Patients at Kisugu Health Centre Iii, Makindye Division, in Uganda

“…Our speciation results differed from those from a study in Nigeria where Aspergillus fumigatus was the most prevalent (43.4%) followed by niger at 16.4 % (Sani et al, 2020). , Another study carried out by Mbarara University teach-ing hospital on pulmonary infection reported several co-species infections though the most common co-aspergilli infection was aspergillus niger and flavus which our study didn't observe, however, aspergillus Niger was the common species isolated which agrees with our study (Njovu et al, 2021). This alone suggests that the chances of co-species infection are likely to be high due to the fact these species can co-exist in the same niche.…”

“…Findings from a study in southwestern Uganda to assess the burden of pulmonary fungal infections found that 17.2% of infections were attributed to aspergillus species this was lower compared to our prevalence value. This difference could be also attributed to the fungal culture method (Njovu et al, 2021). Another study form Nigeria showed that 18.6 % of pulmonary infections were due to aspergillus species (Talle et al, 2017).…”

Prevalence of Anaemia and Pulmonary Mycoses in Immunocompromised Subjects: A Review of Nigeria Perspective

“…This study recorded a prevalence of 8.7%-73.6% among immuno-compromised subjects. The prevalence of 55.6% was reported in Sao Paulo, Brazil among AIDS patients [44], 55.5% in Kano, Nigeria among HIV and TB co-infected subjects [30], 78.6% in Gombe, Nigeria among TB patients [29], 70.7% in Mbarara, South-Western Uganda [45], 12.8% in Beijing, China by Shailaja et al [46], 47.6% in South African [47]. The differences in the prevalence of pulmonary mycoses in various populations may be attributed to the differences in sample size of recruited subjects, variations in the risk factors common to a particular environment, mode of sample collection/processing after collection and diagnostic approaches used.…”