PREVALENCE OF PULMONARY ASPERGILLOSIS AND DRUG SUSCEPTIBILITY TESTING AMONGST ADULT HIV PATIENTS AT KISUGU HEALTH CENTRE III, MAKINDYE DIVISION, IN UGANDA
Keywords:Pulmonary Aspergillosis , Drug Susceptibility testing , HIV, Uganda
Pulmonary aspergillosis is one of the respiratory conditions that are missed to be diagnosed and neglected in Uganda and it has been reported to be common worldwide, especially among people living with HIV. With azole resistance common to aspergillus fumigatus becoming a global concern; a species that causes invasive disease, epidemiological data are necessary to guide clinical practice. This study determined the prevalence of pulmonary aspergillosis and drug susceptibility testing amongst adult HIV patients at Kisugu Health Centre III
A cross-sectional study was carried out at Kisugu Health Centre III among 254 HIV clients. Early morning sputa were cultured on Sabroud Dextrose Agar at 300C for 7 days using a high-volume culture technique. Microscopy using lactophenol cotton blue stain was carried out to identify the species. Antifungal susceptibility testing was done using the agar-based disc diffusion method, and data were analyzed as proportion.
There were 79.5%(N=202) female participants. Participants' mean age was 34.20±10.27 (range: 18-67) years. The prevalence of pulmonary aspergillosis was 42.5% (N=108) with the commonest species being aspergillus niger (28%, N=71), fumigatus (9%, N=23), terreus(4.7%, N=12), co-species infection at 1.2% (N=3). 98.6% of aspergillus niger isolates were sensitive to voriconazole,87.5% of aspergillus fumigatus isolates were sensitive to voriconazole and 100% of the aspergillus terreus isolates were sensitive to voriconazole. Major resistance in this study was seen in aspergillus fumigatus with 12.5% resistance to itraconazole, resistance was also noticed amongst 8.3% of aspergillus terreus isolates on amphotericin B.
The prevalence of Pulmonary aspergillosis was high, and different species were isolated. Moreover, a varied antifungal susceptibility pattern was established
Routine testing for pulmonary aspergillosis should be included in HIV clinics.
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Copyright (c) 2023 Jonah Buyi, Bashir Mwambi, Ivan Mugisha Taremwa
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