Prevalence of Allergic Bronchopulmonary Aspergillosis in Severe Asthma Patients Presenting to a Tertiary Care Hospital in North West India.

BACKGROUND/

INTRODUCTION

The Indian subcontinent faces a substantial healthcare challenge with allergic bronchopulmonary aspergillosis (ABPA). While numerous investigations have explored ABPA's occurrence in the general asthmatic population, there remains a significant knowledge gap regarding its specific prevalence among individuals with severe asthma. Current Indian research demonstrates considerable variation in reported ABPA prevalence rates among severe asthmatics, highlighting the need for more comprehensive investigation.

OBJECTIVE

This research initiative aimed to determine the precise prevalence of ABPA among severe asthma patients seeking treatment at a tertiary healthcare institution in northwestern India, with the goal of enhancing our understanding of this complex condition's burden in this specific patient population.

METHODOLOGY: We conducted a comprehensive cross-sectional investigation spanning August 2022 through July 2023. The study encompassed 247 patients diagnosed with severe asthma. Each participant underwent thorough clinical evaluation and provided blood samples for comprehensive analysis, including absolute eosinophil count measurement, total IgE quantification, and specific testing for Aspergillus fumigatus-related IgE antibodies. When clinically indicated, additional diagnostic procedures included Aspergillus-specific IgG testing and detailed chest imaging through X-ray or high-resolution computed tomography (HRCT).

RESULTS

Our investigation revealed that 63.2% (156 out of 247) of severe asthma patients met the diagnostic criteria for ABPA. The affected population showed a mean age of 41.6 years, with a relatively balanced gender distribution (80 females, 76 males). Among those diagnosed with ABPA, we observed a notably higher prevalence of ABPA-B (92.3%, 144 patients) compared to ABPA-S (7.7%, 12 patients).

CONCLUSION

This research represents one of the most extensive investigations to date documenting such a high ABPA prevalence (63.2%) among severe asthma patients in northern India. These findings underscore the critical need for expanded research initiatives to investigate the underlying factors contributing to such elevated ABPA rates in this geographical region, ultimately aiming to develop and implement effective preventive strategies at the community level.