Chronic pulmonary aspergillosis as a cause of smear negative TB and or anti-TB treatment failure in Nigerians

Rita Oladele; NK Irurhe; P. Foden; Alani S.  Akanmu; T Gbaja-Biamila; A Nwosu; H A Ekundayo; Folasade T Ogunsola; Malcolm Richardson; David Denning

doi:10.5588/ijtld.17.0060

Chronic pulmonary aspergillosis as a cause of smear negative TB and or anti-TB treatment failure in Nigerians

Rita Oladele, NK Irurhe, P. Foden, Alani S. Akanmu , T Gbaja-Biamila, A Nwosu, H A Ekundayo, Folasade T Ogunsola, Malcolm Richardson, David Denning

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Abstract

Objective: We evaluated CPA as an alternative diagnosis of smear negative TB and treatment failure in TB patients in Nigeria.

Methods: We conducted a cross-sectional multicenter survey in HIV positive and negative adult patients at the end of their TB treatment in clinics in Lagos and Ilorin states. All were assessed by clinical examination, chest X-ray and Aspergillus IgG serology and some for sputum fungal culture. CPA was defined as a positive Aspergillus fumigatus IgG titre with compatible chest X-ray or a positive sputum culture of Aspergillus with a visible fungal ball on the chest X-ray with symptoms with underlying lung disease.

Findings: 208 patients were recruited between June 2014 and May 2015. 153 (73.6%) were HIV positive. Mean age was 39.8 years, 124 (59.6%) were female and 39 (18.8%) were unable to work. Median CD4 count (range) was 169.5 cells/ml (4-593) in the HIV infected patients with positive Aspergillus IgG. 109 (52.4%) had documented TB and 140 (67.3%) had productive cough and 50 had haemoptysis. The prevalence of CPA was 8.7%; 10 (6.5%) with HIV infection and 8 (14.5%) HIV negative patients (Fisher’s exact p=0.092).

Conclusion: CPA is a neglected disease in Nigeria, most matching the WHO diagnostic criteria for ‘smear-negative’ tuberculosis.

Original language	English
Pages (from-to)	1056-1061
Number of pages	6
Journal	International Journal of Tuberculosis and Lung Disease
Volume	21
Issue number	9
DOIs	https://doi.org/10.5588/ijtld.17.0060
Publication status	Published - 1 Sept 2017

Keywords

Aspergillosis
tuberculosis
HIV
chronic pulmonary aspergillosis
aspergillus serology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.5588/ijtld.17.0060

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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, 21(9), 1056-1061. https://doi.org/10.5588/ijtld.17.0060

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title = "Chronic pulmonary aspergillosis as a cause of smear negative TB and or anti-TB treatment failure in Nigerians",

abstract = "Objective: We evaluated CPA as an alternative diagnosis of smear negative TB and treatment failure in TB patients in Nigeria.Methods: We conducted a cross-sectional multicenter survey in HIV positive and negative adult patients at the end of their TB treatment in clinics in Lagos and Ilorin states. All were assessed by clinical examination, chest X-ray and Aspergillus IgG serology and some for sputum fungal culture. CPA was defined as a positive Aspergillus fumigatus IgG titre with compatible chest X-ray or a positive sputum culture of Aspergillus with a visible fungal ball on the chest X-ray with symptoms with underlying lung disease.Findings: 208 patients were recruited between June 2014 and May 2015. 153 (73.6%) were HIV positive. Mean age was 39.8 years, 124 (59.6%) were female and 39 (18.8%) were unable to work. Median CD4 count (range) was 169.5 cells/ml (4-593) in the HIV infected patients with positive Aspergillus IgG. 109 (52.4%) had documented TB and 140 (67.3%) had productive cough and 50 had haemoptysis. The prevalence of CPA was 8.7%; 10 (6.5%) with HIV infection and 8 (14.5%) HIV negative patients (Fisher{\textquoteright}s exact p=0.092).Conclusion: CPA is a neglected disease in Nigeria, most matching the WHO diagnostic criteria for {\textquoteleft}smear-negative{\textquoteright} tuberculosis. ",

keywords = "Aspergillosis, tuberculosis, HIV, chronic pulmonary aspergillosis, aspergillus serology",

author = "Rita Oladele and NK Irurhe and P. Foden and Akanmu, {Alani S.} and T Gbaja-Biamila and A Nwosu and Ekundayo, {H A} and Ogunsola, {Folasade T} and Malcolm Richardson and David Denning",

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Oladele, R, Irurhe, NK, Foden, P, Akanmu , AS, Gbaja-Biamila, T, Nwosu, A, Ekundayo, HA, Ogunsola, FT, 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

TY - JOUR

T1 - Chronic pulmonary aspergillosis as a cause of smear negative TB and or anti-TB treatment failure in Nigerians

AU - Oladele, Rita

AU - Irurhe, NK

AU - Foden, P.

AU - Akanmu , Alani S.

AU - Gbaja-Biamila, T

AU - Nwosu, A

AU - Ekundayo, H A

AU - Ogunsola, Folasade T

AU - Richardson, Malcolm

AU - Denning, David

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Objective: We evaluated CPA as an alternative diagnosis of smear negative TB and treatment failure in TB patients in Nigeria.Methods: We conducted a cross-sectional multicenter survey in HIV positive and negative adult patients at the end of their TB treatment in clinics in Lagos and Ilorin states. All were assessed by clinical examination, chest X-ray and Aspergillus IgG serology and some for sputum fungal culture. CPA was defined as a positive Aspergillus fumigatus IgG titre with compatible chest X-ray or a positive sputum culture of Aspergillus with a visible fungal ball on the chest X-ray with symptoms with underlying lung disease.Findings: 208 patients were recruited between June 2014 and May 2015. 153 (73.6%) were HIV positive. Mean age was 39.8 years, 124 (59.6%) were female and 39 (18.8%) were unable to work. Median CD4 count (range) was 169.5 cells/ml (4-593) in the HIV infected patients with positive Aspergillus IgG. 109 (52.4%) had documented TB and 140 (67.3%) had productive cough and 50 had haemoptysis. The prevalence of CPA was 8.7%; 10 (6.5%) with HIV infection and 8 (14.5%) HIV negative patients (Fisher’s exact p=0.092).Conclusion: CPA is a neglected disease in Nigeria, most matching the WHO diagnostic criteria for ‘smear-negative’ tuberculosis.

AB - Objective: We evaluated CPA as an alternative diagnosis of smear negative TB and treatment failure in TB patients in Nigeria.Methods: We conducted a cross-sectional multicenter survey in HIV positive and negative adult patients at the end of their TB treatment in clinics in Lagos and Ilorin states. All were assessed by clinical examination, chest X-ray and Aspergillus IgG serology and some for sputum fungal culture. CPA was defined as a positive Aspergillus fumigatus IgG titre with compatible chest X-ray or a positive sputum culture of Aspergillus with a visible fungal ball on the chest X-ray with symptoms with underlying lung disease.Findings: 208 patients were recruited between June 2014 and May 2015. 153 (73.6%) were HIV positive. Mean age was 39.8 years, 124 (59.6%) were female and 39 (18.8%) were unable to work. Median CD4 count (range) was 169.5 cells/ml (4-593) in the HIV infected patients with positive Aspergillus IgG. 109 (52.4%) had documented TB and 140 (67.3%) had productive cough and 50 had haemoptysis. The prevalence of CPA was 8.7%; 10 (6.5%) with HIV infection and 8 (14.5%) HIV negative patients (Fisher’s exact p=0.092).Conclusion: CPA is a neglected disease in Nigeria, most matching the WHO diagnostic criteria for ‘smear-negative’ tuberculosis.

KW - Aspergillosis

KW - tuberculosis

KW - HIV

KW - chronic pulmonary aspergillosis

KW - aspergillus serology

UR - http://europepmc.org/abstract/med/28826456

U2 - 10.5588/ijtld.17.0060

DO - 10.5588/ijtld.17.0060

M3 - Article

C2 - 28826456

SN - 1027-3719

VL - 21

SP - 1056

EP - 1061

JO - International Journal of Tuberculosis and Lung Disease

JF - International Journal of Tuberculosis and Lung Disease

IS - 9

ER -

Chronic pulmonary aspergillosis as a cause of smear negative TB and or anti-TB treatment failure in Nigerians

Abstract

Keywords

UN SDGs

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MFIG: Manchester Fungal Infection Group (MFIG)

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Chronic pulmonary aspergillosis as a cause of smear negative TB and or anti-TB treatment failure in Nigerians

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Projects

MFIG: Manchester Fungal Infection Group (MFIG)

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