Evaluation of an Aspergillus IgG/IgM lateral flow assay for serodiagnosis of fungal asthma in Uganda
Diagnosis of fungal allergies in asthma remains problematic in low-and middle-income countries due to non-availability of point-of-care testing. In this study, we aimed to evaluate the performance of an Aspergillus immunochromatographic technology (ICT) IgG/M lateral flow device (LFD) for the serolo...
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| creator | Kwizera, Richard Bongomin, Felix Olum, Ronald Worodria, William Bwanga, Freddie Meya, David B Kirenga, Bruce J Gore, Robin Denning, David W Fowler, Stephen J |
| description | Diagnosis of fungal allergies in asthma remains problematic in low-and middle-income countries due to non-availability of point-of-care testing. In this study, we aimed to evaluate the performance of an Aspergillus immunochromatographic technology (ICT) IgG/M lateral flow device (LFD) for the serological diagnosis of allergic bronchopulmonary aspergillosis (ABPA) and severe asthma with fungal sensitisation (SAFS) among Ugandan adult asthmatics. 374 adult (aged [greater than or equal to]18years) asthmatics in the African Severe Asthma Program study, Ugandan site constituted the study population. ABPA and SAFS were diagnosed according to standard criteria. Asthmatics who did not meet the above criteria constituted a control group. The LFD tests were performed and read according to manufacturer's instructions. ABPA was found in 12/374 (3.2%) and SAFS in 60/374 (16%) participants. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the Aspergillus ICT for the diagnosis of ABPA were 0.0%, 96.4%, 0.0% and 96.7% respectively, and for SAFS 6.7%, 97.1%, 30.8% and 84.5% respectively. False positive and negative rates were 3.5% and 3.2% for ABPA and 2.4% and 14.9% for SAFS, respectively. Patients with a positive LFD significantly had higher median Aspergillus fumigatus-specific IgE levels compared to those with negative LFD (median: 0.06 kUA/l VS 0.03 kUA/L, P = 0.011). The Aspergillus ICT IgG/M LFD had a poor diagnostic performance for the diagnosis of both ABPA and SAFS. Its greatest value may be in distinguishing chronic and allergic aspergillosis in Africa. |
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In this study, we aimed to evaluate the performance of an Aspergillus immunochromatographic technology (ICT) IgG/M lateral flow device (LFD) for the serological diagnosis of allergic bronchopulmonary aspergillosis (ABPA) and severe asthma with fungal sensitisation (SAFS) among Ugandan adult asthmatics. 374 adult (aged [greater than or equal to]18years) asthmatics in the African Severe Asthma Program study, Ugandan site constituted the study population. ABPA and SAFS were diagnosed according to standard criteria. Asthmatics who did not meet the above criteria constituted a control group. The LFD tests were performed and read according to manufacturer's instructions. ABPA was found in 12/374 (3.2%) and SAFS in 60/374 (16%) participants. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the Aspergillus ICT for the diagnosis of ABPA were 0.0%, 96.4%, 0.0% and 96.7% respectively, and for SAFS 6.7%, 97.1%, 30.8% and 84.5% respectively. False positive and negative rates were 3.5% and 3.2% for ABPA and 2.4% and 14.9% for SAFS, respectively. Patients with a positive LFD significantly had higher median Aspergillus fumigatus-specific IgE levels compared to those with negative LFD (median: 0.06 kUA/l VS 0.03 kUA/L, P = 0.011). The Aspergillus ICT IgG/M LFD had a poor diagnostic performance for the diagnosis of both ABPA and SAFS. Its greatest value may be in distinguishing chronic and allergic aspergillosis in Africa.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0252553</identifier><identifier>PMID: 34048497</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Allergic bronchopulmonary aspergillosis ; Antibodies ; Antigens ; Aspergillosis ; Aspergillus ; Asthma ; Biology ; Biology and Life Sciences ; Biomedical materials ; Biomedical research ; Bronchus ; Data analysis ; Diagnosis ; Disease control ; Editing ; Evaluation ; Funding ; Fungal infections ; Fungi ; Health sciences ; Hospitals ; Immune response ; Immunity ; Immunoglobulin G ; Immunoglobulin M ; Infections ; Infectious diseases ; Laboratories ; Lungs ; Medical research ; Medicine ; Medicine and Health Sciences ; Methodology ; Microbiology ; Patients ; People and Places ; Performance evaluation ; Population studies ; Pulmonology ; Research facilities ; Serodiagnosis ; Serology ; Visualization</subject><ispartof>PloS one, 2021-05, Vol.16 (5), p.e0252553-e0252553</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Kwizera et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Kwizera et al 2021 Kwizera et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c669t-1e51c749906a1ba90933bf0116141ba7c9e103e56d930b71af108e29fdad3dcd3</citedby><cites>FETCH-LOGICAL-c669t-1e51c749906a1ba90933bf0116141ba7c9e103e56d930b71af108e29fdad3dcd3</cites><orcidid>0000-0002-5270-3539 ; 0000-0001-5626-2251 ; 0000-0003-1289-0111</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8162618/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8162618/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids></links><search><creatorcontrib>Kwizera, Richard</creatorcontrib><creatorcontrib>Bongomin, Felix</creatorcontrib><creatorcontrib>Olum, Ronald</creatorcontrib><creatorcontrib>Worodria, William</creatorcontrib><creatorcontrib>Bwanga, Freddie</creatorcontrib><creatorcontrib>Meya, David B</creatorcontrib><creatorcontrib>Kirenga, Bruce J</creatorcontrib><creatorcontrib>Gore, Robin</creatorcontrib><creatorcontrib>Denning, David W</creatorcontrib><creatorcontrib>Fowler, Stephen J</creatorcontrib><title>Evaluation of an Aspergillus IgG/IgM lateral flow assay for serodiagnosis of fungal asthma in Uganda</title><title>PloS one</title><description>Diagnosis of fungal allergies in asthma remains problematic in low-and middle-income countries due to non-availability of point-of-care testing. In this study, we aimed to evaluate the performance of an Aspergillus immunochromatographic technology (ICT) IgG/M lateral flow device (LFD) for the serological diagnosis of allergic bronchopulmonary aspergillosis (ABPA) and severe asthma with fungal sensitisation (SAFS) among Ugandan adult asthmatics. 374 adult (aged [greater than or equal to]18years) asthmatics in the African Severe Asthma Program study, Ugandan site constituted the study population. ABPA and SAFS were diagnosed according to standard criteria. Asthmatics who did not meet the above criteria constituted a control group. The LFD tests were performed and read according to manufacturer's instructions. ABPA was found in 12/374 (3.2%) and SAFS in 60/374 (16%) participants. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the Aspergillus ICT for the diagnosis of ABPA were 0.0%, 96.4%, 0.0% and 96.7% respectively, and for SAFS 6.7%, 97.1%, 30.8% and 84.5% respectively. False positive and negative rates were 3.5% and 3.2% for ABPA and 2.4% and 14.9% for SAFS, respectively. Patients with a positive LFD significantly had higher median Aspergillus fumigatus-specific IgE levels compared to those with negative LFD (median: 0.06 kUA/l VS 0.03 kUA/L, P = 0.011). The Aspergillus ICT IgG/M LFD had a poor diagnostic performance for the diagnosis of both ABPA and SAFS. Its greatest value may be in distinguishing chronic and allergic aspergillosis in Africa.</description><subject>Allergic bronchopulmonary aspergillosis</subject><subject>Antibodies</subject><subject>Antigens</subject><subject>Aspergillosis</subject><subject>Aspergillus</subject><subject>Asthma</subject><subject>Biology</subject><subject>Biology and Life Sciences</subject><subject>Biomedical materials</subject><subject>Biomedical research</subject><subject>Bronchus</subject><subject>Data analysis</subject><subject>Diagnosis</subject><subject>Disease control</subject><subject>Editing</subject><subject>Evaluation</subject><subject>Funding</subject><subject>Fungal infections</subject><subject>Fungi</subject><subject>Health sciences</subject><subject>Hospitals</subject><subject>Immune response</subject><subject>Immunity</subject><subject>Immunoglobulin G</subject><subject>Immunoglobulin M</subject><subject>Infections</subject><subject>Infectious 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of an Aspergillus IgG/IgM lateral flow assay for serodiagnosis of fungal asthma in Uganda</title><author>Kwizera, Richard ; Bongomin, Felix ; Olum, Ronald ; Worodria, William ; Bwanga, Freddie ; Meya, David B ; Kirenga, Bruce J ; Gore, Robin ; Denning, David W ; Fowler, Stephen J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c669t-1e51c749906a1ba90933bf0116141ba7c9e103e56d930b71af108e29fdad3dcd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Allergic bronchopulmonary aspergillosis</topic><topic>Antibodies</topic><topic>Antigens</topic><topic>Aspergillosis</topic><topic>Aspergillus</topic><topic>Asthma</topic><topic>Biology</topic><topic>Biology and Life Sciences</topic><topic>Biomedical materials</topic><topic>Biomedical research</topic><topic>Bronchus</topic><topic>Data analysis</topic><topic>Diagnosis</topic><topic>Disease 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In this study, we aimed to evaluate the performance of an Aspergillus immunochromatographic technology (ICT) IgG/M lateral flow device (LFD) for the serological diagnosis of allergic bronchopulmonary aspergillosis (ABPA) and severe asthma with fungal sensitisation (SAFS) among Ugandan adult asthmatics. 374 adult (aged [greater than or equal to]18years) asthmatics in the African Severe Asthma Program study, Ugandan site constituted the study population. ABPA and SAFS were diagnosed according to standard criteria. Asthmatics who did not meet the above criteria constituted a control group. The LFD tests were performed and read according to manufacturer's instructions. ABPA was found in 12/374 (3.2%) and SAFS in 60/374 (16%) participants. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the Aspergillus ICT for the diagnosis of ABPA were 0.0%, 96.4%, 0.0% and 96.7% respectively, and for SAFS 6.7%, 97.1%, 30.8% and 84.5% respectively. False positive and negative rates were 3.5% and 3.2% for ABPA and 2.4% and 14.9% for SAFS, respectively. Patients with a positive LFD significantly had higher median Aspergillus fumigatus-specific IgE levels compared to those with negative LFD (median: 0.06 kUA/l VS 0.03 kUA/L, P = 0.011). The Aspergillus ICT IgG/M LFD had a poor diagnostic performance for the diagnosis of both ABPA and SAFS. Its greatest value may be in distinguishing chronic and allergic aspergillosis in Africa.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34048497</pmid><doi>10.1371/journal.pone.0252553</doi><tpages>e0252553</tpages><orcidid>https://orcid.org/0000-0002-5270-3539</orcidid><orcidid>https://orcid.org/0000-0001-5626-2251</orcidid><orcidid>https://orcid.org/0000-0003-1289-0111</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Allergic bronchopulmonary aspergillosis Antibodies Antigens Aspergillosis Aspergillus Asthma Biology Biology and Life Sciences Biomedical materials Biomedical research Bronchus Data analysis Diagnosis Disease control Editing Evaluation Funding Fungal infections Fungi Health sciences Hospitals Immune response Immunity Immunoglobulin G Immunoglobulin M Infections Infectious diseases Laboratories Lungs Medical research Medicine Medicine and Health Sciences Methodology Microbiology Patients People and Places Performance evaluation Population studies Pulmonology Research facilities Serodiagnosis Serology Visualization |
| title | Evaluation of an Aspergillus IgG/IgM lateral flow assay for serodiagnosis of fungal asthma in Uganda |
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