{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T17:29:09Z","timestamp":1775064549316,"version":"3.50.1"},"reference-count":55,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:label\/>\n                  <jats:p>Fungal sensitization is associated with poor asthma control. We aimed to determine the prevalence and factors associated with fungal asthma among Ugandan adults. Individuals aged\u00a0\u226518 years with a new diagnosis of asthma in the last 12 months participating in the African Severe Asthma Program constituted the study population. Skin prick test results, clinical and demographic data were retrieved from the database, and serum Aspergillus fumigatus specific antibodies and total IgE were measured in stored blood. We enrolled 374 patients, median (IQR) age 34 (25\u201345) years, 286 (76.5%) females and 286 (76.5%) with severe asthma. Prevalence of Aspergillus fumigatus sensitization was 42.0% (95% CI: 37.1\u201347.0%), allergic bronchopulmonary aspergillosis (ABPA) 3.2% (1.8\u20135.5%), severe asthma with fungal sensitization (SAFS) 16% (12.7\u201320.1%) and allergic bronchopulmonary mycosis (ABPM) 2.9% (1.7\u20135.2%). Older age (55\u201364 years) (crude odds ratio (cOR) = 2.6), sensitization to at least one allergen (cOR\u00a0=\u00a09.38) and hypertension (cOR\u00a0=\u00a01.99) were significantly associated with Aspergillus sensitization, whereas tertiary education level (cOR\u00a0=\u00a00.29), severe depression (cOR\u00a0=\u00a00.15) and strong emotions (cOR\u00a0=\u00a00.47) were not. High occupational exposure to Aspergillus (cOR\u00a0=\u00a04.26) and contact with moulds (cOR\u00a0=\u00a014.28) were significantly associated with ABPA. Palpitations (cOR\u00a0=\u00a05.54), uncontrolled asthma (cOR\u00a0=\u00a03.54), eczema\/dermatitis (cOR\u00a0=\u00a03.07), poor lung function (cOR\u00a0=\u00a02.11) and frequent exacerbations (cOR\u00a0=\u00a01.01) were significantly associated with SAFS. Eczema\/dermatitis (cOR\u00a0=\u00a01.55) was significantly associated with ABPM, but cold weather trigger (cOR\u00a0=\u00a00.24) was not. Fungal asthma is a significant problem among Ugandans with asthma and should be particularly considered in individuals who remain uncontrolled despite optimal standard of care for asthma, as it is responsive to available and affordable oral antifungal therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Lay Summary<\/jats:title>\n                  <jats:p>This study showed that fungal asthma is a significant problem among Ugandans with asthma with a high prevalence. Fungal asthma should be considered in patients with uncontrolled asthma despite receiving optimal standard of care. This is the first modern attempt to define these endotypes of asthma in Africa.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/mmy\/myab023","type":"journal-article","created":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T15:11:05Z","timestamp":1617030665000},"page":"923-933","source":"Crossref","is-referenced-by-count":11,"title":["Fungal asthma among Ugandan adult asthmatics"],"prefix":"10.1093","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5270-3539","authenticated-orcid":false,"given":"Richard","family":"Kwizera","sequence":"first","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University, P.O. Box 22418, Kampala, Uganda"},{"name":"Makerere University Lung Institute, College of Health Sciences, Makerere University, P.O. Box 7749, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Bongomin","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Gulu University, P.O. Box, 166, Gulu, Uganda"},{"name":"Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald","family":"Olum","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David B","family":"Meya","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, College of Health Sciences, Makerere University, P.O. Box 22418, Kampala, Uganda"},{"name":"Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Worodria","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda"},{"name":"Division of Pulmonology, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freddie","family":"Bwanga","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen J","family":"Fowler","sequence":"additional","affiliation":[{"name":"Manchester Fungal Infection Group, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin","family":"Gore","sequence":"additional","affiliation":[{"name":"Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David W","family":"Denning","sequence":"additional","affiliation":[{"name":"Manchester Fungal Infection Group, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce J","family":"Kirenga","sequence":"additional","affiliation":[{"name":"Makerere University Lung Institute, College of Health Sciences, Makerere University, P.O. 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