The Impact of Chronic Pulmonary Aspergillosis Co-infection on the Health-Related Quality of Life of Patients with Pulmonary Tuberculosis in Uganda

Namusobya, Martha; Bongomin, Felix; Mukisa, John; Batte, Charles; Olwit, William; Rhein, Joshua; Sekaggya-Wiltshire, Christine; Prasad, Shailendra

doi:10.1007/s11046-023-00741-1

Cited by 2 publications

(4 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our recent study from Mulago Hospital (Kampala, Uganda) found that 32 (20%) of 162 patients with PTB who had persistent respiratory symptoms despite completing 2 months of TB treatment had CPA, 19 with patients with CPA-PTB co-infection having a much worse health-related quality of life at the time of TB treatment completion compared to those with PTB alone. 18 We reported death in a patient with CPA complicating PTB, with heart failure, 99 use of point of care lateral flow assay for Aspergillus specific immunoglobulin G and M (IgG/IgM) detection for early screening for CPA 100 and demonstrated that CPA is frequently misdiagnosed as PTB relapse among Ugandans with chronic respiratory symptoms following PTB treatment. 101 …”

Section: Discussionmentioning

confidence: 98%

“…Our recent work has shown that Ugandans with CPA-PTB co-infection have a poorer health-related quality of life compared to those with only PTB. 18 …”

Section: Discussionmentioning

confidence: 99%

“…The first-ever estimate of the burden of serious fungal diseases in Uganda was published in 2015, highlighting important opportunistic fungal infections (OFIs) in human immunodeficiency virus (HIV) infection and knowledge gaps. 10 Since then, additional data on HIV-related OFIs, 11 – 14 deep mycoses, 15 , 16 and studies on chronic pulmonary aspergillosis (CPA) in post-tuberculosis (TB) 17 and in active TB 18 , 19 populations have been published, providing us with more reflective local data to improve the robustness of the estimate of CPA. Also, several high-quality local data have been published on other important risk factors for fungal diseases including asthma 20 – 24 and chronic obstructive pulmonary disease (COPD) 25 and the population size has changed significantly.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Re-estimation of the burden of serious fungal diseases in Uganda

Bongomin,

Kwizera,

Namusobya

et al. 2024

Therapeutic Advances in Infection

Self Cite

View full text Add to dashboard Cite

Background: It is of utmost importance to monitor any change in the epidemiology of fungal diseases that may arise from a change in the number of the at-risk population or the availability of local data. Objective: We sought to update the 2015 publication on the incidence and prevalence of serious fungal diseases in Uganda. Methods: Using the Leading International Fungal Education methodology, we reviewed published data on fungal diseases and drivers of fungal diseases in Uganda. Regional or global data were used where there were no Ugandan data. Results: With a population of ~45 million, we estimate the annual burden of serious fungal diseases at 4,099,357 cases (about 9%). We estimated the burden of candidiasis as follows: recurrent Candida vaginitis (656,340 cases), oral candidiasis (29,057 cases), and esophageal candidiasis (74,686 cases) in HIV-infected people. Cryptococcal meningitis annual incidence is estimated at 5553 cases, Pneumocystis pneumonia at 4604 cases in adults and 2100 cases in children. For aspergillosis syndromes, invasive aspergillosis annual incidence (3607 cases), chronic pulmonary aspergillosis (26,765 annual cases and 63,574 5-year-period prevalent cases), and prevalence of allergic bronchopulmonary aspergillosis at 75,931 cases, and severe asthma with fungal sensitization at 100,228 cases. Tinea capitis is common with 3,047,989 prevalent cases. For other mycoses, we estimate the annual incidence of histoplasmosis to be 646 cases and mucormycosis at 9 cases. Conclusion: Serious fungal diseases affect nearly 9% of Ugandans every year. Tuberculosis and HIV remain the most important predisposition to acute fungal infection necessitating accelerated preventive, diagnostic, and therapeutic interventions for the management of these diseases.

show abstract

Section: Discussionmentioning

confidence: 98%

“…Our recent work has shown that Ugandans with CPA-PTB co-infection have a poorer health-related quality of life compared to those with only PTB. 18 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Re-estimation of the burden of serious fungal diseases in Uganda

Bongomin,

Kwizera,

Namusobya

et al. 2024

Therapeutic Advances in Infection

Self Cite

View full text Add to dashboard Cite

show abstract

“…In this study, we were able to show that asthma and restrictive lung disease contributed to an additional 25% of participants with chronic respiratory symptoms. We have previously shown that chronic pulmonary aspergillosis (CPA) occurs in up to 20% of PTB patients with persistent symptoms (24), significantly affecting their quality of life during PTB treatment (25). Therefore, investigations for both infectious complications and ventilatory defects are indicated in patients with chronic respiratory symptoms following completion of PTB treatment.…”

Section: Discussionmentioning

confidence: 99%

Chronic respiratory symptoms and chronic obstructive pulmonary disease following completion of pulmonary tuberculosis treatment in Uganda

Namusobya,

Bongomin,

John

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Background Prior pulmonary tuberculosis (PTB) is associated with chronic lung impairment, including chronic obstructive pulmonary disease (COPD). We determined the prevalence and associations of chronic respiratory symptoms and COPD following completion of PTB treatment in Uganda. Methods Between August 2022 and December 2022, we consecutively enrolled post-PTB patients who had successfully completed PTB treatment between January 2016 and January 2020 at Mulago National Referral Hospital, Kampala, Uganda. Chronic respiratory symptoms were defined as the presence of at least one of the following symptoms lasting for at least three months within a year: cough or sputum production, shortness of breath, chest pain, or wheezing, along with an FEV1/FVC < 0.70 on spirometry for the definition of COPD. Results We enrolled 326 participants (median age 36 years; IQR: 30 — 43), 182 (55.8%) were male, and 123 (37.7%) were living with HIV. Fifty-one (15.6%) participants had chronic respiratory symptoms, 5 (9.8%) having COPD; 4 GOLD I and 1 GOLD II. Chronic respiratory symptoms were 89% lower among participants whose PTB treatment outcome was “completed” (adjusted Odds Ratio (aOR): 0.11, 95% confidence interval (CI): 0.01 – 0.87, p<0.01) and they were 74% lower among those with alcohol use disorders (aOR: 0.26, 95% CI: 0.12 – 0.57, p <0.001). Non-HIV immunosuppressive conditions such as diabetes mellitus and chronic steroid use, were significantly associated with both chronic respiratory symptoms (aOR:7.72, 95% CI 3.13 – 19.04, p<0.001) and COPD (aOR: 8.42, 95% CI: 1.32 — 53.47, p=0.024). Conclusion Chronic pulmonary symptoms, including COPD, are important and yet under recognized complications of PTB treatment in Uganda. Therefore, screening and management in key sub-groups, such as those with immunosuppressive condition, will improve morbidity and quality of life in this population.

show abstract

The Impact of Chronic Pulmonary Aspergillosis Co-infection on the Health-Related Quality of Life of Patients with Pulmonary Tuberculosis in Uganda

Cited by 2 publications

References 27 publications

Re-estimation of the burden of serious fungal diseases in Uganda

Re-estimation of the burden of serious fungal diseases in Uganda

Chronic respiratory symptoms and chronic obstructive pulmonary disease following completion of pulmonary tuberculosis treatment in Uganda

Contact Info

Product

Resources

About