CPA Patients with a history of TB.
<div><p>Background</p><p>Chronic pulmonary aspergillosis (CPA) is a disease commonly caused by <i>Aspergillus fumigatus</i> and other <i>Aspergillus</i> species characterized by cavitary lung lesions. Tea garden population is an agrarian population of...
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2025
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| Summary: | <div><p>Background</p><p>Chronic pulmonary aspergillosis (CPA) is a disease commonly caused by <i>Aspergillus fumigatus</i> and other <i>Aspergillus</i> species characterized by cavitary lung lesions. Tea garden population is an agrarian population of Assam, mostly associated with tea plantations. Assam is a major tea-producing state with 803 tea gardens producing approximately 50% of the total tea in India, of which 177 are present in the Dibrugarh district alone. Tuberculosis is common in tea garden workers. This community-based cross-sectional study in the tea garden community of Dibrugarh was done to find the prevalence of <i>Aspergillus</i> IgG antibodies and CPA cases in individuals with chronic respiratory symptoms.</p><p>Methodology and principal findings</p><p>Patients visiting 3 tea garden hospitals and 2 referral hospitals with chronic cough and/or haemoptysis, weight loss/fatigue, and other respiratory symptoms for a duration of 3 months or more were included in this one-year study. Serum samples were tested by Immunocap Phadia 200 for <i>Aspergillus fumigatus</i>-specific IgG antibodies. CPA cases were diagnosed based on clinical, radiological, and serological criteria. Out of 128 samples, seropositivity was seen in 41 (32.0%) patients (cutoff value: 27 mgA/l). Male preponderance (1.6:1) with a mean age of 41.9 (±15.69) was observed. Haemoptysis and fatigue were significant symptoms seen (p-values: 0.0086 and 0.0098, respectively). <i>Aspergillus fumigatus</i>-specific IgG antibody was found to be significantly high in 29 out of 76 patients (38.1%) with a history of tuberculosis. Amongst them, seropositivity with active TB was 5 out of 27 patients (18.5%), and seropositivity with post-TB was 24 out of 49 patients (48.9%). Chronic cavitary pulmonary aspergillosis was the predominant type (38.1%). Proven CPA (clinically, radiologically, and serologically positive) were 22 (17.1%, 95% CI 10.7%–26.0%), and possible CPA (clinically and serologically positive but without radiological data) were 19 (14.8%, 95% CI 8.9%–23.1%).</p><p>Conclusion</p><p>A high prevalence of CPA (60 per 100 000) was detected. High <i>Aspergillus</i> seropositivity of 48.9% was seen in the post-TB population. <i>Aspergillus</i>-specific IgG antibody testing is the only confirmatory method for diagnosing CPA, which is available in limited centres in India. <i>Aspergillus</i> seropositivity should be detected in post-TB patients presenting with chronic respiratory symptoms.</p></div> |
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