Invasive Aspergillosis among Haematological Malignancy Patients in Ghana: A Pilot Study on Prevalence and Antifungal Prophylaxis at the National Referral Hospital

• Published in: West African journal of medicine Vol. 40; no. 6; p. 613
• Main Authors: Ocansey, B K, Otoo, B, Gbadamosi, H, Opintan, J A, Dei-Adomakoh, Y, Kosmidis, C, Denning, D W
• Format: Journal Article
• Language: English
• Published: Nigeria 29-06-2023
• Subjects: Adult; Antifungal Agents - therapeutic use; Aspergillosis - diagnosis; Aspergillosis - drug therapy; Aspergillosis - epidemiology; Ghana - epidemiology; Hematologic Neoplasms - complications; Hospitals, Teaching; Humans; Leukemia; Neutropenia; Pilot Projects; Prevalence; Ghana; Antifungal prophylaxis; Haematological malignancy; Ghana; Invasive aspergillosis; Aspergillus galactomannan; Neutropenia
• ISSN: 0189-160X

Invasive aspergillosis (IA) among haematological malignancy patients is rarely diagnosed or studied in many African countries. Aspergillus galactomannan (GM) enzyme immunoassay (EIA) utilized in aiding diagnosis is not readily accessible in Ghana. Previous studies have evaluated the IMMY sōna Aspergillus GM lateral flow assay (LFA) and suggested it as a potential alternative to the GM EIA.
We aimed to use the LFA in international (EORTC/ MSGERC) definitions to obtain preliminary data on IA among patients with haematological malignancies in Ghana with a focus on the prevalence and antifungal prophylaxis.
We conducted a pilot study among patients with haematological malignancies at the Korle-Bu Teaching Hospital, Ghana using the LFA, culture and computed tomography scan to screen for and classify IA cases according to international definitions.
A total of 56 adult patients were recruited including acute leukaemia 14 (25.0%), chronic leukaemia 38 (67.9%), and lymphoma 4 (7.1%). Nine (16.1%) patients had a history of severe neutropenic episodes. All patients were on at least one chemotherapy drug. Three (5.4%) patients met the criteria for IA, comprising two probable IA in acute myeloid leukaemia and one possible IA in non-Hodgkin's lymphoma and constitutes one of five (20%) patients with ongoing severe neutropenia. The LFA was diagnostic in two IA patients. The IA cases were among 49 (87.5%) patients who did not receive antifungal prophylaxis.
Proactive diagnostic approaches to IA and effective antifungal prophylaxis may be significant in the management of haematological malignancy patients with severe neutropenia in Ghana.