Multi-country estimate of different manifestations of aspergillosis in cystic fibrosis.

Aspergillus spp. can lead to allergic bronchopulmonary aspergillosis (ABPA), Aspergillus sensitisation and Aspergillus bronchitis in CF. The relative frequencies of these entities have recently been ascertained in a large UK adult CF cohort. We have used this data to estimate the burden of aspergill...

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Autores principales:	Joanne Armstead, Julie Morris, David W Denning
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ad21d80b15134aaa802f263a6f9200a3
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spelling	oai:doaj.org-article:ad21d80b15134aaa802f263a6f9200a32021-11-18T08:16:24ZMulti-country estimate of different manifestations of aspergillosis in cystic fibrosis.1932-620310.1371/journal.pone.0098502https://doaj.org/article/ad21d80b15134aaa802f263a6f9200a32014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24914809/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203Aspergillus spp. can lead to allergic bronchopulmonary aspergillosis (ABPA), Aspergillus sensitisation and Aspergillus bronchitis in CF. The relative frequencies of these entities have recently been ascertained in a large UK adult CF cohort. We have used this data to estimate the burden of aspergillosis and ABPA cases in adult CF patients in 30 countries reporting CF. National and international CF registry data was accessed and assessed for completeness and age distribution. Published proportions of ABPA (17.7%), Aspergillus sensitisation (14.6%) and Aspergillus bronchitis (30%) in CF were applied to those >18 years and compared with notified ABPA cases. Of the 76,201 estimated CF patients worldwide (not including India), 37,714 were >18 years. The proportion of adults to children varied from 63% in Norway to 20% in Brazil. ABPA caseload in adults is anticipated to be 6,675 cases of which only 2,221 cases (33%) are currently recorded, indicating substantial underdiagnosis. The ABPA diagnosis rate compared with estimated rates varies by country from 101% (France) to 14.5% (Greece), although genetic variation could account for genuine differences compared with the UK. Aspergillus bronchitis is not currently recognised or recorded in CF registries but there are an anticipated 10,988 adult cases. Aspergillus sensitisation, associated with increased bronchiectasis and reduced FEV1, affects an anticipated 5,506 patients without ABPA or Aspergillus bronchitis. Together ABPA and Aspergillus bronchitis are estimated to affect 17,989 adults, 47.7% of the adult CF population. ABPA also occurs in children and teenagers and 984 cases were documented in registries. Diagnosed ABPA rates by age were available for the ECFS registry, USA, UK, Ireland, Belgium and Netherlands. The rate was <1% under 4 years, and increased throughout childhood and adolescence, with marked variation between countries. Newly published diagnostic criteria and methods should facilitate better recognition of aspergillosis in CF, allowing better CF disease control.Joanne ArmsteadJulie MorrisDavid W DenningPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 6, p e98502 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Joanne Armstead Julie Morris David W Denning Multi-country estimate of different manifestations of aspergillosis in cystic fibrosis.
description	Aspergillus spp. can lead to allergic bronchopulmonary aspergillosis (ABPA), Aspergillus sensitisation and Aspergillus bronchitis in CF. The relative frequencies of these entities have recently been ascertained in a large UK adult CF cohort. We have used this data to estimate the burden of aspergillosis and ABPA cases in adult CF patients in 30 countries reporting CF. National and international CF registry data was accessed and assessed for completeness and age distribution. Published proportions of ABPA (17.7%), Aspergillus sensitisation (14.6%) and Aspergillus bronchitis (30%) in CF were applied to those >18 years and compared with notified ABPA cases. Of the 76,201 estimated CF patients worldwide (not including India), 37,714 were >18 years. The proportion of adults to children varied from 63% in Norway to 20% in Brazil. ABPA caseload in adults is anticipated to be 6,675 cases of which only 2,221 cases (33%) are currently recorded, indicating substantial underdiagnosis. The ABPA diagnosis rate compared with estimated rates varies by country from 101% (France) to 14.5% (Greece), although genetic variation could account for genuine differences compared with the UK. Aspergillus bronchitis is not currently recognised or recorded in CF registries but there are an anticipated 10,988 adult cases. Aspergillus sensitisation, associated with increased bronchiectasis and reduced FEV1, affects an anticipated 5,506 patients without ABPA or Aspergillus bronchitis. Together ABPA and Aspergillus bronchitis are estimated to affect 17,989 adults, 47.7% of the adult CF population. ABPA also occurs in children and teenagers and 984 cases were documented in registries. Diagnosed ABPA rates by age were available for the ECFS registry, USA, UK, Ireland, Belgium and Netherlands. The rate was <1% under 4 years, and increased throughout childhood and adolescence, with marked variation between countries. Newly published diagnostic criteria and methods should facilitate better recognition of aspergillosis in CF, allowing better CF disease control.
format	article
author	Joanne Armstead Julie Morris David W Denning
author_facet	Joanne Armstead Julie Morris David W Denning
author_sort	Joanne Armstead
title	Multi-country estimate of different manifestations of aspergillosis in cystic fibrosis.
title_short	Multi-country estimate of different manifestations of aspergillosis in cystic fibrosis.
title_full	Multi-country estimate of different manifestations of aspergillosis in cystic fibrosis.
title_fullStr	Multi-country estimate of different manifestations of aspergillosis in cystic fibrosis.
title_full_unstemmed	Multi-country estimate of different manifestations of aspergillosis in cystic fibrosis.
title_sort	multi-country estimate of different manifestations of aspergillosis in cystic fibrosis.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/ad21d80b15134aaa802f263a6f9200a3
work_keys_str_mv	AT joannearmstead multicountryestimateofdifferentmanifestationsofaspergillosisincysticfibrosis AT juliemorris multicountryestimateofdifferentmanifestationsofaspergillosisincysticfibrosis AT davidwdenning multicountryestimateofdifferentmanifestationsofaspergillosisincysticfibrosis
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Multi-country estimate of different manifestations of aspergillosis in cystic fibrosis.

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