Chronic pulmonary aspergillosis (CPA) is an emerging fungal infectious disease of public health importance. We conducted a systematic review of studies reporting the outcomes of patients with CPA managed surgically in Africa. A search of Medline, Embase, Web of Science, Google Scholar and African Journals Online was conducted to identify studies indexed from inception to June 2021 that examined surgical management of CPA in Africa. All articles that presented primary data, including case reports and case series, were included. We excluded review articles. A total of 891 cases (557 males (62.5%), mean age 39.3 years) extracted from 27 eligible studies published between 1976 and 2020 from 11 African countries were included. Morocco (524, 59%) and Senegal (99, 11%) contributed the majority of cases. Active or previous pulmonary tuberculosis was reported in 677 (76.0%) cases. Haemoptysis was reported in 682 (76.5%) cases. Lobectomy (either unilateral or bilateral, n = 493, 55.3%), pneumonectomy (n = 154, 17.3%) and segmentectomy (n = 117, 13.1%) were the most frequently performed surgical procedures. Thirty (4.9%) cases from South Africa received bronchial artery embolisation. Empyema (n = 59, 27.4%), significant haemorrhage (n = 38, 173.7%), incomplete lung expansion (n = 26, 12.1%) and prolonged air leak (n = 24, 11.2%) were the most frequent complications. Overall, 45 (5.1%) patients died. The causes of death included respiratory failure (n = 14), bacterial superinfection/sepsis (n = 10), severe haemorrhage (n = 5), cardiopulmonary arrest (n = 3) and complications of chronic obstructive pulmonary disease (n = 3). The cause of death was either unknown or unspecified in 9 cases. We conclude that surgical treatment had very low mortality rates and maybe considered as first-line management option in centres with experience and expertise in Africa.

中文翻译：

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非洲慢性肺曲霉病的外科治疗：对 891 例病例的系统评价

慢性肺曲霉病 (CPA) 是一种新兴的具有公共卫生重要性的真菌传染病。我们对报告在非洲接受手术治疗的 CPA 患者的结果的研究进行了系统评价。对 Medline、Embase、Web of Science、Google Scholar 和 Africa Journals Online 进行了搜索，以确定从开始到 2021 年 6 月索引的研究，这些研究检查了非洲 CPA 的手术管理。所有提供主要数据的文章，包括病例报告和病例系列，都包括在内。我们排除了评论文章。共纳入 891 例病例（557 例男性（62.5%），平均年龄 39.3 岁），来自 11 个非洲国家在 1976 年至 2020 年间发表的 27 项符合条件的研究。摩洛哥 (524, 59%) 和塞内加尔 (99, 11%) 贡献了大部分病例。677 例（76.0%）病例报告了活动性或既往肺结核。有 682 例（76.5%）病例报告了咯血。肺叶切除术（单侧或双侧，n = 493, 55.3%）、全肺切除术（n = 154, 17.3%）和肺段切除术（n = 117, 13.1%）是最常进行的外科手术。来自南非的 30 例 (4.9%) 病例接受了支气管动脉栓塞术。脓胸 (n = 59, 27.4%)、大出血 (n = 38, 173.7%)、肺扩张不完全 (n = 26, 12.1%) 和长时间漏气 (n = 24, 11.2%) 是最常见的并发症。总体而言，45 (5.1%) 名患者死亡。死亡原因包括呼吸衰竭（n = 14）、细菌重复感染/败血症（n = 10）、严重出血（n = 5）、心肺骤停（n = 3）和慢性阻塞性肺疾病并发症（n = 3） . 9 例死亡原因不明或未明确。我们得出结论，手术治疗的死亡率非常低，在非洲有经验和专业知识的中心可能被视为一线治疗选择。