{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:38:28Z","timestamp":1791898708232,"version":"4.3.4"},"reference-count":51,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T00:00:00Z","timestamp":1722211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Indonesian Science Fund (Dana Ilmu Pengetahuan Indonesia\/Lembaga Pengelolaan Dana Pendidikan (DIPI\/LPDP)","award":["MR\/P017622\/1"],"award-info":[{"award-number":["MR\/P017622\/1"]}]},{"DOI":"10.13039\/501100000265","name":"UK Medical Research Council","doi-asserted-by":"publisher","award":["MR\/P017622\/1"],"award-info":[{"award-number":["MR\/P017622\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>In Indonesia, 2.4% of all new tuberculosis patients had multi-drug resistant disease (MDR-TB); an estimated 24,000 incidences. Historical case series of MDR-TB described a high frequency of cavitation and poor prognosis. The diagnosis of chronic pulmonary aspergillosis (CPA) relies on raised levels of Aspergillus IgG antibodies, and detectable Histoplasma IgG antibodies are suspicious for chronic pulmonary histoplasmosis (CPH). We investigated whether MDR-TB patients might have concurrent CPH or CPA. This was a cross-sectional study with 50 MDR-TB patients. ELISA was used to detect Histoplasma IgG antibodies and lateral flow assay was used to detect Aspergillus IgG\/IgM antibodies. Several other possible disease determinants were assessed by multivariate analysis. Of the 50 MDR-TB patients, 14 (28%) and 16 (32%) had positive Histoplasma or Aspergillus serology; six patients (12%) had dual antibody reactivity. Radiological abnormalities in positive patients included diffuse or local infiltrates, nodules, consolidation, and apical cavities, consistent with CPH and CPA. Patients with detectable fungal antibodies tended to have worse disease, and 4 of 26 (15.3%) died in the first 5 months of dual infection (p = 0.11 compared with no deaths in those with only MDR-TB). The criteria for the diagnosis of CPH and CPA were fulfilled in those with moderately and far advanced disease (13 of 14 or 93%) and 12 of 16 (75%), respectively. Damp housing was the only determinant associated with Histoplasma antibodies (PR 2.01; 95%CI 0.56\u20137.19), while pets were associated with the Aspergillus antibody (PR 18.024; 95%CI 1.594\u2013203.744). CPA or CPH are probably frequent in MDR-TB patients in Indonesia and may carry a worse prognosis.<\/jats:p>","DOI":"10.3390\/jof10080529","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T16:37:17Z","timestamp":1722271037000},"page":"529","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The Association of Chronic Pulmonary Aspergillosis and Chronic Pulmonary Histoplasmosis with MDR-TB Patients in Indonesia"],"prefix":"10.3390","volume":"10","author":[{"given":"Noni N.","family":"Soeroso","sequence":"first","affiliation":[{"name":"Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Universitas Sumatera Utara Hospital, Medan 20155, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lambok","family":"Siahaan","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Faculty of Medicine, Universitas Sumatera Utara, Medan 20155, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8805-2423","authenticated-orcid":false,"given":"Selfi","family":"Khairunnisa","sequence":"additional","affiliation":[{"name":"Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Universitas Sumatera Utara Hospital, Medan 20155, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raden Ajeng Henny","family":"Anggriani","sequence":"additional","affiliation":[{"name":"Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Universitas Sumatera Utara Hospital, Medan 20155, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8257-1451","authenticated-orcid":false,"given":"Aida","family":"Aida","sequence":"additional","affiliation":[{"name":"Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Universitas Sumatera Utara Hospital, Medan 20155, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Putri C.","family":"Eyanoer","sequence":"additional","affiliation":[{"name":"Department of Community and Preventive Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan 20155, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvita R.","family":"Daulay","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, Universitas Sumatera Utara, Medan 20155, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erlina","family":"Burhan","sequence":"additional","affiliation":[{"name":"Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta 13230, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Rozaliyani","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia"},{"name":"Lung Mycosis Centre, Department of Parasitology, Faculty of Medicine, Persahabatan Hospital, Universitas Indonesia, Jakarta 13230, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronny","family":"Ronny","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Faculty of Medicine, Universitas Kristen Indonesi, Jakarta 13630, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robiatul","family":"Adawiyah","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia"},{"name":"Lung Mycosis Centre, Department of Parasitology, Faculty of Medicine, Persahabatan Hospital, Universitas Indonesia, Jakarta 13230, Indonesia"},{"name":"Clinical Parasitology Study Programme, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5626-2251","authenticated-orcid":false,"given":"David W.","family":"Denning","sequence":"additional","affiliation":[{"name":"Manchester Fungal Infection Group, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Retno","family":"Wahyuningsih","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia"},{"name":"Lung Mycosis Centre, Department of Parasitology, Faculty of Medicine, Persahabatan Hospital, Universitas Indonesia, Jakarta 13230, Indonesia"},{"name":"Department of Parasitology, Faculty of Medicine, Universitas Kristen Indonesi, Jakarta 13630, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,29]]},"reference":[{"key":"ref_1","unstructured":"WHO (2023, November 23). 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