ArticleBMC infectious diseases2022
Serological evidence of chronic pulmonary Aspergillosis in tuberculosis patients in Kenya.
Article in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 15 citations in OpenAlex.
- Hypercalcemia in a Patient With Spinal Tuberculosis and Aspergillus Co-Infection: A Case-Report.Immunity, inflammation and disease · 2026Article
- Performance of the LDBioMicrobiology spectrum · 2026Article
- Aspergillosis: An Update on Epidemiology, Risk Factors, Diagnosis, Susceptibility, and Treatment.Journal of fungi (Basel, Switzerland) · 2026Review
- Secondary infections following tuberculosis: epidemiology, pathogenesis and clinical implications.Breathe (Sheffield, England) · 2026Review
- A retrospective study exploring chronic pulmonary aspergillosis in post-tuberculosis lung disease patients.Journal of thoracic disease · 2025Article
- Characteristics and risk factors of pulmonary fungal infection in patients with pulmonary tuberculosis.American journal of translational research · 2025Article
- Chronic pulmonary aspergillosis in tea population of Assam.PLoS neglected tropical diseases · 2025Article
- Observational
- Prevalence and predictors of Aspergillus seropositivity and chronic pulmonary aspergillosis in an urban tertiary hospital in Sierra Leone: A cross-sectional study.PLoS neglected tropical diseases · 2023Article
- Burden of fungal infections in Kenya.Mycology · 2023Article
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPulmonary tuberculosis (PTB) is a significant risk factor for fungal infection. The cavitary lesions post PTB serves as a good reservoir for fungal colonization and subsequent infection. Furthermore, the severe immunosuppression associated with HIV and TB co-infection is another predisposition. The inadequate capacity to investigate and manage fungal infection in PTB patients increases their morbidity and mortality. The study aimed to provide serological evidence of chronic pulmonary aspergillosis (CPA) among PTB patients in Kenya. Towards this, we analysed 234 serum samples from patients presenting with persistent clinical features of PTB infections despite TB treatment in four referral hospitals.
methodsThis was a cross sectional laboratory based study and patients were recruited following an informed consent. Serological detection of Aspergillus fumigatus IgG was done using enzyme-linked immunosorbent assay (Bordier Affinity Products SA). Sputum samples were subjected to microscopy and standard fungal culture. The isolated fungi were subjected to macro and micro morphological identifications and confirmed by sequence analysis of calmadulin, betatubilin and ITS genes.
resultsSerological evidence of CPA or fungal sensitization was 46(19.7%) and equivocal or borderline was 14(6.0%). Mycological investigations of sputum resulted in 88(38%) positive for fungal culture. Aspergillus spp. accounted for 25(28%) of which A. fumigatus was 13(14.8%), A. niger 8(9.1%), A. terreus, A. flavus, A. candidus and A. clavatus 1 (1.1%) each. This was followed by Penicillium spp. 10 (11.4%), Scedosporium spp. 5 (5.7%) and Rhizopus spp. 3 (3.4%). Among the yeasts; Candida albicans accounted for 18(20.5%) followed by C. glabrata 5(5.7%). Cryptococcus spp. was isolated from 3(3.4%) of the samples while 13(14.8%) were other yeasts.
conclusionChronic pulmonary aspergillosis is a significant co-morbidity in PTB patients in Kenya that could be misdiagnosed as relapse or treatment failures in the absence of reliable diagnostic and clinical management algorithm. It could be the cause of persistent clinical symptoms despite TB treatment often misdiagnosed as TB smear/GeneXpert MTB/RIF® negative or relapse. We recommend that all patients with persistent clinical symptoms despite TB treatment should be subjected to fungal investigations before retreatment.
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