Assessment of Galactomannan for the diagnosis of invasive aspergillosis in pediatric aplastic anemia patients in UP, India

Abstract

Invasive aspergillosis (IA) is a dangerous form of fungal infection, especially for those who already have weakened immune systems. particularly pediatric patients with Aplastic Anemia (AA). This is very important for getting an early and correct diagnosis of IA so that treatment can begin quickly and patients have better results. The purpose of this research was to evaluate Galactomannan's (GM) diagnostic value in detecting IA in children with AA in Uttar Pradesh (UP), India. A study that involved children with AA diagnoses and clinical characteristics that suggested they might have IA was done prospectively through observation. Serum samples were collected from each participant and analyzed using the Galactomannan assay. The Galactomannan index (GMI) cutoff value of ≥0.5 was considered positive for IA. Additional diagnostic tests, including clinical evaluation, radiological findings, and microbiological investigations, were performed to determine the presence of IA and validate the GM results. The study enrolled a total of 100 pediatric AA patients, of whom 25 were diagnosed with IA based on comprehensive diagnostic criteria. Calculations were done to determine the GM assay's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), as well as its diagnostic accuracy. The findings showed that the diagnostic accuracy was 90%, the sensitivity was 80%, the specificity was 92%, the positive predictive value was 76%, and the negative predictive value was 94%. Furthermore, the study evaluated the association between GM levels and disease severity in IA casesWhen comparing patients with localized infections to those with more severe types of IA, those with disseminated and invasive infections had considerably higher GM levels. This finding indicates that GM levels may serve as a potential prognostic marker for disease severity in pediatric AA patients with IA. In conclusion, highlights the potential of galactomannan as a valuable diagnostic tool for the detection of invasive aspergillosis in pediatric aplastic anemia patients in Uttar Pradesh, India. The high sensitivity, specificity, and diagnostic accuracy observed that the GM assay can aid in the early identification of IA, enabling timely treatment initiation and potentially improving patient outcomes. In order to determine the best method for diagnosing IA in this particular patient population and scenario, more research and validation studies are required.