ĭetection of Aspergillus IgG in serum is the core of laboratory assessments for CPA. A recent study showed 13% patients at the end of TB therapy in Indonesia developed CPA. Based on TB surveillance data of Indonesia, the total prevalence estimate of CPA in the country is ~83,000 patients with 17,561 new cases of CPA after pulmonary tuberculosis (PTB) every year. Additionally, Indonesia also contributed to the global increase in newly diagnosed TB cases with a 69% increase from 2015 to 2019. Indonesia has one of the highest burdens of tuberculosis with estimated total TB incidence of 312 per 100,000 population in 2019 with high mortality rates (34 deaths per 100,000 HIV-negative TB population). The rate of CPA at the end of TB therapy in smear-negative, HIV-negative patients was 14.5% in a prior study in Nigeria. The survival rate of CPA can be as low as 47% at 10 years depending on grade of lung damage and risk factors presence in patients. This emerging disease affects more than 3 million people around the world, mainly survivors of pulmonary tuberculosis (TB) with estimates suggesting that more than 100,000 people develop CPA yearly as a consequence of TB. Although CPA is an unrecognised disease in Indonesia, this study suggests that more than one in five GeneXpert negative patients with persistent symptoms following completion of TB therapy may have CPA.Īspergillosis can present as a chronic and progressive disease of the lung, called chronic pulmonary aspergillosis (CPA). Logistic regression revealed a positive LDBio Aspergillus ICT result, smoking history and diabetes to be important predictors of CPA diagnosis. The LDBio test was positive in 16 (80%) CPA patients and in 21 (30%) non-CPA patients ( p < 0.001) with 80% sensitivity and 70% specificity. Twenty (22%) out of 90 patients met the criteria for CPA. CPA was diagnosed on the basis of symptoms for ≥3 months, characteristic chest imaging and positive Aspergillus culture. This study aims to determine the CPA rate in HIV-negative, GeneXpert-negative patients presenting with symptoms following completion of TB therapy and to evaluate the performance of LDBio Aspergillus immunochromatographic technology (ICT) lateral flow assay in the diagnosis of CPA. There are a lack of studies on the prevalence of CPA in GeneXpert/smear-negative TB patients in Indonesia, despite a high number of TB cases.
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Aspergillus IgG detection is the cornerstone of CPA diagnosis. The diagnosis of CPA is difficult and often misdiagnosed as smear-negative TB in endemic settings. Chronic pulmonary aspergillosis (CPA) is a common sequela of pulmonary tuberculosis (TB).