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"Latar belakang: Aspergilosis paru kronik (APK) merupakan penyakit paru destruktif yang bersifat progresif terutama disebabkan infeksi Aspergillus fumigatus. Penyakit ini dapat menjadi komplikasi infeksi tuberkulosis (TB) dan menyebabkan morbiditas serta mortalitas signifikan. Diagnosis APK masih menjadi tantangan karena gejala klinis tidak khas, serta belum ada alat diagnosis yang cepat dan akurat. Deteksi IgG Aspergillus berbasis lateral flow assay (LFA) menggunakan metode imunokromatografi (ICT) merupakan uji cepat dan sederhana untuk membantu diagnosis APK. Penelitian ini bertujuan untuk mengetahui hubungan uji ICT Aspergillus dengan karakteristik klinis dan radiologis APK pada pasien terkait TB paru.Metode: Penelitian berdesain potong lintang ini dilaksanakan pada April 2019-Juli 2023 dan merupakan bagian dari penelitian sebelumnya tentang diagnosis APK di Indonesia. Serum pasien APK diperiksa di Laboratorium Mikologi Departemen Parasitologi FKUI untuk deteksi ICT Aspergillus, kemudian dilanjutkan dengan analisis hasil penelitian.Hasil: Sebanyak 29 dari 54 (54%) serum pasien yang diteliti menunjukkan hasil uji ICT Aspergillus positif. Proporsi jenis kelamin perempuan (63%) lebih banyak dibandingkan laki-laki, sedangkan usia terbanyak 30-60 tahun (74%). Gejala klinis terbanyak adalah fatigue (57%), batuk ≥ 3 bulan (42%), hemoptisis (41%) diikuti sesak napas (24%), dan nyeri dada (20%). Adapun penyakit penyerta terbanyak adalah diabetes melitus (20%), penyakit kardiovaskular (11%), dan PPOK (9%). Gambaran radiologi paling dominan adalah kavitas (94%), diikuti infiltrat (72%), dan penebalan pleura (55%). Analisis statistik menunjukkan kaitan bermakna antara hasil ICT Aspergillus positif dengan gambaran radiologi berupa infiltrat, fibrosis parakavitas, fibrosis, efusi pleura, konsolidasi dan bronkiektasis (p <0,005). Hasil ICT Aspergillus tidak menunjukkan kemaknaan statistik dengan karakteristik klinis.Simpulan: Deteksi IgG spesifik Aspergillus metode ICT pada 54 pasien APK pada penelitian ini menunjukkan hasil positif 54%. Pada penelitian ini hasil ICT Aspergillus menunjukkan kaitan bermakna secara statistik dengan gambaran radiologi, tetapi tidak menunjukkan kaitan bermakna dengan karakteristik klinis pasien.

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Background: Chronic pulmonary aspergillosis (CPA) is a progressive, destructive lung disease mainly caused by Aspergillus fumigatus infection. The disease can be a complication of tuberculosis (TB) infection and cause significant morbidity and mortality. Diagnosis of CPA is still challenging because the clinical symptoms are not typical, and there are no fast and accurate diagnostic tools. Detection of IgG-specific Aspergillus using the immunochromatography (ICT) method is a quick and simple test to assist CPA diagnosis. The study aimed to determine the correlation between the ICT Aspergillus test and the clinical and radiological characteristics of CPA in TB-related patients.

Method: This cross-sectional study was carried out in April 2019-July 2023 and was part of a previous study on CPA diagnosis in Indonesia. All sera of CPA patients were examined at the Clinical Parasitology Laboratory, Faculty of Medicine Universitas Indonesia for ICT Aspergillus detection, followed by analysis of the study results.

Result: Twenty-nine of the 54 patient sera showed positive results of ICT Aspergillus. There were more female (76%) than male patients, with the majority aged 30–60 years (74%). The most common clinical symptoms were fatigue (57%), cough ≥3 months (42%), hemoptysis (41%), shortness of breath (24%), and chest pain (20%). The most common comorbidities were diabetes mellitus (20%), cardiovascular diseases (11%), and COPD (9%). The dominant of radiological features were cavities (94%), followed by infiltrates (72%), and pleural thickening (55%). The statistical analysis showed a significant correlation between positive ICT Aspergillus results and radiological features, including infiltrates, paracavity fibrosis, fibrosis, pleural effusion, consolidation, and bronchiectasis. However, the ICT Aspergillus did not show statistical significance with clinical characteristics.

Conclusion: The ICT Aspergillus detection in this study showed positive results of 54%. There was a significant correlation between ICT Aspergillus positive result with radiology features, but no significant correlation with clinical characteristics."

"Latar belakang: Aspergilosis paru kronik (APK) merupakan komplikasi yang sering menyebabkan munculnya sekuela respiratori pada pasien bekas tuberkulosis (TB) paru. Diagnosis APK dapat dilakukan dengan pemeriksaan serologi IgG spesifik Aspergillus. Metode tersebut memerlukan waktu tertentu, sumber daya, dan fasilitas khusus, sehingga sulit diterapkan di fasilitas kesehatan dengan sumber daya terbatas. Metode baru Immunocromatography Test (ICT) LD Bio Aspergillus dilaporkan lebih mudah digunakan, cepat dan murah; tetapi akurasi diagnostiknya belum diketahui di Indonesia. Tujuan: Penelitian ini bertujuan untuk mengetahui akurasi diagnostik LD Bio ICT Aspergillus dibandingkan dengan IgG spesifik Aspergillus pada pasien bekas TB. Metode: Penelitian dengan desain potong lintang ini dilakukan dari April 2019 – Oktober 2020. Perekrutan subjek dilakukan di RSUP Persahabatan dan prosedur pemeriksaan mikologi dilakukan di Laboratorium Parasitologi FKUI. Serum pasien bekas TB diperiksa menggunakan LD Bio ICT Aspergillus dan IgG spesifik Aspergillus Dynamiker ELISA. Hasil kedua pemeriksaan dibandingkan untuk melihat akurasi diagnosis LD Bio ICT. Hasil: Dari 82 pasien yang sesuai dengan kriteria inklusi, terdapat 57 pasien (69,5%) laki-laki, rerata usia pasien 51,27±12,55 tahun. Median IMT 18,67 (10,38-31,18). Sebanyak 40 pasien (48,7%) menunjukkan hasil positif IgG spesifik Aspergillus. Adapun hasil positif LD Bio ICT Aspergillus didapatkan pada 35 pasien (42,7%). Sensitivitas dan spesifisitas LD Bio ICT dibandingkan dengan pemeriksaan IgG spesifik Aspergillus adalah 50,0% dan 64,3%, sedangkan nilai duga positif dan negatifnya adalah 57,1% dan 57,5%. Simpulan: LD Bio ICT dapat digunakan untuk mendiagnosis APK pada pasien bekas TB Paru di fasilitas kesehatan dengan sumber daya terbatas.

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Background: Chronic pulmonary aspergillosis (CPA) is a common complication following prior pulmonary tuberculosis (TB) causing respiratory sequelae. Although CPA may lead to worse prognosis, it is still underdiagnosed. Serology test such as Aspergillus-specific IgG is the recommended test for CPA diagnosis. However, this diagnostic procedure is time-consuming, require a lot of resources and certain skills, making this procedure not always easy to implement in limited facilities. The LDBio Diagnostic introduced a novel, affordable, and easy to use serology test, LD Bio Immunocromatography Test (ICT). Nevertheless, LD Bio ICT’s diagnostic accuracy in Indonesia is still unknown.

Study aims: This study aimed to determine the diagnostic accuracy of LD Bio ICT with Aspergillus-specific IgG as comparison in previous pulmonary TB patients.

Methods: This cross-sectional study was conducted in April 2019 – October 2020. Subject recrutment was done in National Referral Centre Persahabatan Hospital and serological test was conducted in the Parasitology Laboratory, Faculty of Medicine Universitas Indonesia. Eighty two sera of previous pulmonary TB patients were serologically tested using LD Bio ICT Aspergillus (France) and Aspergillus-specific IgG was tested using Dynamiker ELISA kit. Results of both tests were then compared to determine the diagnostic accuracy of LD Bio ICT.

Results: Of 82 patients met the inclusion criteria, 57 patients (69.5%) were men, the mean age was 51.27±12.55 years old. The BMI median was 18.67 (10.38-31.18). Forty patients (48.7%) showed positive Aspergillus-specific IgG Dynamiker results. Meanwhile, 35 patients (42.7%) showed positive results of LD Bio ICT Aspergillus. Compared to this finding, LD Bio ICT sensitivity and specificity were 50.0% and 64.3% respectively. In addition, the positive and negative prediction value of LD Bio ICT in this study were 57.1% and 57.5%.

Summary: LD Bio ICT is useful for the diagnosis of CPA in previous pulmonary TB patients in resource-limited settings."