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 ≥18 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 (25–45) years, 286 (76.5%) females and 286 (76.5%) with severe asthma. Prevalence of Aspergillus fumigatus sensitization was 42.0% (95% CI: 37.1–47.0%), allergic bronchopulmonary aspergillosis (ABPA) 3.2% (1.8–5.5%), severe asthma with fungal sensitization (SAFS) 16% (12.7–20.1%) and allergic bronchopulmonary mycosis (ABPM) 2.9% (1.7–5.2%). Older age (55–64 years) (crude odds ratio (cOR) = 2.6), sensitization to at least one allergen (cOR = 9.38) and hypertension (cOR = 1.99) were significantly associated with Aspergillus sensitization, whereas tertiary education level (cOR = 0.29), severe depression (cOR = 0.15) and strong emotions (cOR = 0.47) were not. High occupational exposure to Aspergillus (cOR = 4.26) and contact with moulds (cOR = 14.28) were significantly associated with ABPA. Palpitations (cOR = 5.54), uncontrolled asthma (cOR = 3.54), eczema/dermatitis (cOR = 3.07), poor lung function (cOR = 2.11) and frequent exacerbations (cOR = 1.01) were significantly associated with SAFS. Eczema/dermatitis (cOR = 1.55) was significantly associated with ABPM, but cold weather trigger (cOR = 0.24) 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. Lay Summary 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.

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乌干达成人哮喘患者中的真菌性哮喘

真菌致敏与哮喘控制不佳有关。我们旨在确定乌干达成年人真菌性哮喘的患病率和相关因素。参与非洲严重哮喘项目的年龄≥18 岁且在过去 12 个月内新诊断为哮喘的个体构成研究人群。从数据库中检索皮肤点刺试验结果、临床和人口统计数据，并在储存的血液中测量血清烟曲霉特异性抗体和总 IgE。我们招募了 374 名患者，中位 (IQR) 年龄为 34 (25-45) 岁，286 名 (76.5%) 女性和 286 名 (76.5%) 患有严重哮喘。烟曲霉致敏的患病率为 42.0% (95% CI: 37.1–47.0%)，过敏性支气管肺曲霉病 (ABPA) 为 3.2% (1.8–5.5%)，真菌致敏重度哮喘 (SAFS) 为 16% (12.7–20)。1%) 和过敏性支气管肺真菌病 (ABPM) 2.9% (1.7–5.2%)。年龄较大（55-64 岁）（粗比值比 (cOR) = 2.6）、对至少一种过敏原的敏感性 (cOR = 9.38) 和高血压 (cOR = 1.99) 与曲霉菌致敏显着相关，而高等教育水平 (cOR) = 0.29)、严重的抑郁症 (cOR = 0.15) 和强烈的情绪 (cOR = 0.47) 没有。曲霉的高职业暴露 (cOR = 4.26) 和霉菌接触 (cOR = 14.28) 与 ABPA 显着相关。心悸 (cOR = 5.54)、哮喘未控制 (cOR = 3.54)、湿疹/皮炎 (cOR = 3.07)、肺功能差 (cOR = 2.11) 和频繁恶化 (cOR = 1.01) 与 SAFS 显着相关。湿疹/皮炎 (cOR = 1.55) 与 ABPM 显着相关，但寒冷天气触发因素 (cOR = 0.24) 则不然。真菌性哮喘是乌干达哮喘患者的一个重要问题，尽管对哮喘进行了最佳护理标准，但仍无法控制的个体应特别考虑这一问题，因为它对可用且负担得起的口服抗真菌治疗有反应。总结 本研究表明，真菌性哮喘是乌干达哮喘高发人群的一个重要问题。尽管接受了最佳护理标准，但哮喘未控制的患者应考虑真菌性哮喘。这是在非洲定义这些哮喘内型的首次现代尝试。总结 本研究表明，真菌性哮喘是乌干达哮喘高发人群的一个重要问题。尽管接受了最佳护理标准，但哮喘未控制的患者应考虑真菌性哮喘。这是在非洲定义这些哮喘内型的首次现代尝试。总结 本研究表明，真菌性哮喘是乌干达哮喘高发人群的一个重要问题。尽管接受了最佳护理标准，但哮喘未控制的患者应考虑真菌性哮喘。这是在非洲定义这些哮喘内型的首次现代尝试。