Chronic pulmonary aspergillosis incidence in newly detected pulmonary tuberculosis cases during follow‐up
This article has been Reviewed by the following groups
Listed in
- Evaluated articles (Rapid Reviews Infectious Diseases)
Abstract
Background
Chronic pulmonary aspergillosis (CPA) is known to complicate patients with post‐tubercular lung disease. However, some evidence suggests that CPA might co‐exist in patients with newly‐diagnosed pulmonary tuberculosis (P.TB) at diagnosis and also develop during therapy. The objective of this study was to confirm the presence of CPA in newly diagnosed P.TB at baseline and at the end‐of‐TB‐therapy.
Materials and Methods
This prospective longitudinal study included newly diagnosed P.TB patients, followed up at third month and end‐of‐TB‐therapy with symptom assessment, anti‐ Aspergillus IgG antibody and imaging of chest for diagnosing CPA.
Results
We recruited 255 patients at baseline out of which 158 (62%) completed their follow‐up. Anti‐ Aspergillus IgG was positive in 11.1% at baseline and 27.8% at end‐of‐TB‐therapy. Overall, proven CPA was diagnosed in 7% at baseline and 14.5% at the end‐of‐TB‐therapy. Around 6% patients had evidence of aspergilloma in CT chest at the end‐of‐TB‐therapy.
Conclusions
CPA can be present in newly diagnosed P.TB patients at diagnosis and also develop during anti‐tubercular treatment. Patients with persistent symptoms or developing new symptoms during treatment for P.TB should be evaluated for CPA. Whether patients with concomitant P.TB and CPA, while receiving antitubercular therapy, need additional antifungal therapy, needs to be evaluated in future studies.
Article activity feed
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Erlina Burhan, Muhammad Ilham Dhiya Rakasiwi
Review 5: "Chronic Pulmonary Aspergillosis Incidence in Newly Detected Pulmonary Tuberculosis Cases during Follow-up"
Reviewers were mixed, with some finding the study well-written and important while others had concerns about generalizability, misclassification of CPA/TB, and interpretability of findings.
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Kathirvel Soundappan
Review 4: "Chronic Pulmonary Aspergillosis Incidence in Newly Detected Pulmonary Tuberculosis Cases during Follow-up"
Reviewers were mixed, with some finding the study well-written and important while others had concerns about generalizability, misclassification of CPA/TB, and interpretability of findings.
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Oxana Munteanu
Review 3: "Chronic Pulmonary Aspergillosis Incidence in Newly Detected Pulmonary Tuberculosis Cases during Follow-up"
Reviewers were mixed, with some finding the study well-written and important while others had concerns about generalizability, misclassification of CPA/TB, and interpretability of findings.
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Retno Wahyuningsih
Review 2: "Chronic Pulmonary Aspergillosis Incidence in Newly Detected Pulmonary Tuberculosis Cases during Follow-up"
Reviewers were mixed, with some finding the study well-written and important while others had concerns about generalizability, misclassification of CPA/TB, and interpretability of findings.
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Yeonsoo Baik
Review 1: "Chronic Pulmonary Aspergillosis Incidence in Newly Detected Pulmonary Tuberculosis Cases during Follow-up"
Reviewers were mixed, with some finding the study well-written and important while others had concerns about generalizability, misclassification of CPA/TB, and interpretability of findings.
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Strength of evidence
Reviewers:Y Baik(Johns Hopkins)|📒📒📒 ◻️◻️
R Wahyuningsih(Universitas Kristen)|📘📘📘📘📘
O Munteanu(Nicolae Testemitanu State University of Medicine and Pharmacy)|📒📒📒◻️◻️
K Soundappan(PGIMER)|📒📒📒 ◻️◻️
E Burhan & M I D Rakasiwi (Univeritas Indonesia)|📒📒📒 ◻️◻️ -
