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Review
. 2023 Mar 1;13(5):922.
doi: 10.3390/diagnostics13050922.

Aspergillus Sensitization and Allergic Bronchopulmonary Aspergillosis in Asthmatic Children: A Systematic Review and Meta-Analysis

Ritesh Agarwal  1 , Valliappan Muthu  1 , Inderpaul Singh Sehgal  1 , Sahajal Dhooria  1 , Kuruswamy Thurai Prasad  1 , Kathirvel Soundappan  2 , Shivaprakash Mandya Rudramurthy  3 , Ashutosh Nath Aggarwal  1 , Arunaloke Chakrabarti  4
Affiliations
Review

Aspergillus Sensitization and Allergic Bronchopulmonary Aspergillosis in Asthmatic Children: A Systematic Review and Meta-Analysis

Ritesh Agarwal et al. Diagnostics (Basel). .

Abstract

Background: The prevalence of aspergillus sensitization (AS) and allergic bronchopulmonary aspergillosis (ABPA) in asthmatic children remains unclear. Objective: To systematically review the literature to estimate the prevalence of AS and ABPA in children with bronchial asthma. Methods: We searched the PubMed and Embase databases for studies reporting the prevalence of AS or ABPA in pediatric asthma. The primary outcome was to assess the prevalence of AS, while the secondary outcome was to evaluate the prevalence of ABPA. We pooled the prevalence estimates using a random effects model. We also calculated the heterogeneity and publication bias. Results: Of the 11,695 records retrieved, 16 studies with 2468 asthmatic children met the inclusion criteria. Most studies were published from tertiary centers. The pooled prevalence of AS in asthma (15 studies; 2361 subjects) was 16.1% (95% confidence intervals [CI], 9.3-24.3). The prevalence of AS was significantly higher in prospective studies, studies from India, and those from developing countries. The pooled prevalence of ABPA in asthma (5 studies; 505 children) was 9.9% (95% CI, 0.81-27.6). There was significant heterogeneity and publication bias for both outcomes. Conclusions: We found a high prevalence of AS and ABPA in asthmatic children. There is a need for community-based studies from different ethnicities using a standard methodology to ascertain the true prevalence of AS and ABPA in pediatric asthma.

Keywords: ABPM; allergic bronchopulmonary mycosis; allergic fungal airway disease; cystic fibrosis; fungal asthma; fungal sensitization.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study selection process for the systematic review.
Figure 2
Figure 2
Forest plot for the pooled prevalence of aspergillus sensitization in asthmatic children. The prevalence reported in the individual studies is represented by the black square with horizontal bars indicating the 95% confidence interval. The diamond at the bottom refers to the pooled prevalence with a 95% confidence interval [9,39,41,42,43,44,45,46,47,48,49,50,51,52,53].
Figure 3
Figure 3
Funnel plot showing significant publication bias for the outcome of aspergillus sensitization in children with bronchial asthma. The proportion and standard error are displayed along the horizontal and vertical axes, respectively.
Figure 4
Figure 4
Forest plot showing the pooled prevalence of allergic bronchopulmonary aspergillosis in pediatric asthma. The prevalence in individual studies is shown by the black square with horizontal bars indicating the 95% confidence interval. The diamond denotes the pooled prevalence with a 95% confidence interval [9,40,46,47,53].
See this image and copyright information in PMC

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