Abstract
<b>Background:</b> The diagnosis of CPA relies on the detection of IgG <i>Aspergillus</i> antibody which is not freely available especially in resource-poor settings. Point-of-care tests like LDBio, evaluated in only a few studies, has shown promising results for diagnosis of CPA. However no study has compared the diagnostic performances of LDBio in setting of tuberculosis endemic countries and have compared it with that of IgG <i>Aspergillus</i>. <b>Objectives:</b> It was to evaluate the diagnostic performances of LDBio (ICT lateral flow assay) in CPA and compare it with existing diagnostic algorithm utilising ImmunoCAP IgG <i>Aspergillus</i>. <b>Methods:</b> Serial patients presenting with respiratory symptoms for > 4 weeks were prospectively screened for eligibility. Relevant investigations including microbiological tests, IgG <i>Aspergillus</i>, chest imaging etc were done. Serum were tested by LDBio and IgG <i>Aspergillus</i> (ImmunoCAP) and their diagnostic performances were compared. <b>Results:</b> : In this study, 218 patients were screended and 174 patients (66.7% patients having past history of tuberculosis). A diagnosis of CPA was made in 42.5% of patients. The estimated sensitivity and specificity of LDBio was 67.6% (95% CI: 55.7%- 78%) and 81% (95% CI: 71.9%-81%) respectively which increased to 73.3% and 83.9% respectively in post-tuberculosis sequelae. The sensitivity and specificity of IgG Aspergillus was 82.4% and 82% ; 86.7% and 80.4% in the whole group and those with past history of tuberculosis respectively. <b>Conclusions:</b> LDBio is a point-of-care test with reasonable sensitivity and specificity. However, further tests may have to be done to rule-in or rule-out the diagnosis of CPA in the appropriate setting.
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Published Version
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