Chronic pulmonary aspergillosis as a cause of smear-negative TB and/or TB treatment failure in Nigerians
| Autor: | Philip Foden, Rita O. Oladele, David W. Denning, NK Irurhe, Alani S Akanmu, Folasade Ogunsola, Malcolm Richardson, T Gbaja-Biamila, Halimat Ayodele Ekundayo, Augustina O. Nwosu |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
0301 basic medicine Pathology HIV Infections Aspergillosis Serology Surveys and Questionnaires Prevalence Treatment Failure Aged 80 and over medicine.diagnostic_test Nigerians Chronic pulmonary aspergillosis Neglected Diseases Middle Aged Aspergillus Infectious Diseases Female medicine.symptom Adult Pulmonary and Respiratory Medicine medicine.medical_specialty Tuberculosis Adolescent aspergillus serology 030106 microbiology Nigeria Sputum culture Young Adult 03 medical and health sciences Tuberculosis diagnosis Internal medicine medicine Humans Antibodies Fungal Aged business.industry Sputum HIV medicine.disease Cross-Sectional Studies Case-Control Studies Immunoglobulin G Chronic Disease Pulmonary Aspergillosis business |
| Zdroj: | Oladele, R, Irurhe, NK, Foden, P, Akanmu, A S, Gbaja-Biamila, T, Nwosu, A, Ekundayo, H A, Ogunsola, F T, Richardson, M & Denning, D 2017, ' Chronic pulmonary aspergillosis as a cause of smear negative TB and or anti-TB treatment failure in Nigerians ', International Journal of Tuberculosis and Lung Disease, vol. 21, no. 9, pp. 1056-1061 . https://doi.org/10.5588/ijtld.17.0060 |
| ISSN: | 1027-3719 |
| Popis: | Objective To evaluate chronic pulmonary aspergillosis (CPA) as an alternative diagnosis of smear-negative tuberculosis (TB) and treatment failure in TB patients in Nigeria. Methods We conducted a cross-sectional multicentre survey in human immunodeficiency virus (HIV) positive and negative adult patients at the end of their TB treatment in clinics in Lagos and Ilorin states. All were assessed using clinical examination, chest X-ray (CXR) and aspergillus immunoglobulin G (IgG) serology, and some for sputum fungal culture. CPA was defined as a positive Aspergillus fumigatus IgG titre with compatible CXR or a positive sputum culture of Aspergillus with a visible fungal ball on CXR with symptoms of underlying lung disease. Results Of 208 patients recruited between June 2014 and May 2015, 153 (73.6%) were HIV-positive. The mean age was 39.8 years, 124 (59.6%) were female and 39 (18.8%) were unable to work. The median CD4 count was 169.5 cells/ml (range 4-593) in HIV-infected patients with positive Aspergillus IgG. Overall, 109 (52.4%) had documented TB, 140 (67.3%) had a productive cough and 50 had haemoptysis. CPA prevalence was 8.7%; 10 (6.5%) had HIV infection and 8 (14.5%) were HIV-negative (Fisher's exact P = 0.092). Conclusion CPA is a neglected disease in Nigeria, and most cases match the World Health Organization diagnostic criteria for smear-negative TB. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|