The prevalence of allergic bronchopulmonary aspergillosis (ABPA) in asthmatic patients remains unclear and is likely different across geographic locales.
To systematically review the literature for estimating the prevalence of Aspergillus sensitization (AS) and ABPA in adults with bronchial asthma.
We searched the PubMed and Embase databases for studies reporting the prevalence of AS or ABPA in at least 50 asthmatics. The primary outcome was to assess the prevalence of ABPA. The secondary outcomes were to evaluate the prevalence of AS in asthma and ABPA in asthma with AS. We pooled the prevalence estimates using a random effects model and examined the factors influencing the prevalence using multivariate meta-regression.
Of the 11,801 records retrieved, 86 studies with 25,770 asthmatic subjects met the inclusion criteria. Most of the studies were from tertiary centers. The pooled prevalence of ABPA in asthma (47 studies; 9822 asthmatics) was 11.3% (95% confidence intervals [CI], 8.7-14.2). The pooled prevalence of AS in asthma (73 studies; 23,003 asthmatics) was 25.1% (95% CI, 20.5-30.0), while the prevalence of ABPA in AS (36 studies; 2954 asthmatics) was 37.0% (95% CI, 27.9-46.6). Multivariate meta-regression identified studies published from India (OR 1.11; 95% CI, 1.01-1.23) as the only factor associated with higher ABPA prevalence. There was presence of significant statistical heterogeneity and publication bias.
We found a high prevalence of ABPA in adult asthmatics, underscoring the need for screening all asthmatic subjects attending tertiary care for ABPA.
Copyright © 2023. Published by Elsevier Inc.
