Increasing awareness, diagnosis and treatment of aspergillosis

Increasing awareness, diagnosis and treatment of aspergillosis

Plan:

  1. Summary
  2. UK-specific
  3. Global
  4. Useful examples to follow

 

⭐ Overall Strategy: Use a “Two-Layer” Campaign Model

Layer 1 — “All Aspergillosis” general awareness
Layer 2 — Condition-specific micro-campaigns (CPA, ABPA, Aspergillus bronchitis, SAFS)

This gives you broad visibility and the depth needed to influence actual clinical behaviour.

✔️ Why not choose just one?

  • If you talk only about “aspergillosis” as a whole, it becomes too vague and non-actionable.

  • If you run only condition-specific campaigns, you risk splitting your message and confusing clinicians who don’t know the differences.

The two-layer system solves this.

🟦 Layer 1 – “All Aspergillosis” Core Campaign

Purpose

  • Establish aspergillosis as a major, under-recognised cause of chronic respiratory disease.

  • Create the simple message:
    “If you see chronic symptoms + cavities + bronchiectasis + failed antibiotics → think Aspergillus.”

Main messages

  • Underdiagnosis: Estimated 3–4 per 100,000 with CPA; NAC seeing only ~15–25%.

  • High-risk groups: TB survivors, COPD, bronchiectasis, severe asthma, structurally abnormal lungs, immunosuppressed patients.

  • Variation in diagnosis across England: Severe inequity.

  • NAC/NHS specialist pathway: Fully-funded diagnostics + antifungal monitoring + MDT.

  • When to refer: Simple checklist.

Target audiences

  • GPs

  • Respiratory consultants

  • Infectious diseases

  • Radiologists

  • NHS ICBs & ICS leadership

  • International clinicians in low-/middle-income settings

  • Patient groups

Outputs

  • High-level infographics

  • UK map showing detection gaps

  • “When to refer” one-page tool

  • Simple slides for conferences

  • LinkedIn posts for clinicians

  • Animated patient stories

🟩 Layer 2 – Condition-Specific Micro-Campaigns

Each needs its own messaging because risk factors, symptoms, and referral triggers differ significantly.

1️⃣ Chronic Pulmonary Aspergillosis (CPA)

Purpose

Earlier recognition and more referrals to NAC.

Key messages

  • Look for cavities, nodules, pleural thickening

  • TB and COPD survivors are highest-yield

  • Long-term antibiotics failing = red flag

  • Haemoptysis is common and dangerous

  • 5-year mortality ~50% without treatment

  • IgG testing + HRCT + referral = gold standard

Who to target

Respiratory physicians, radiologists, TB clinics, COPD care teams.

2️⃣ Allergic Bronchopulmonary Aspergillosis (ABPA)

Purpose

Stop misdiagnosis as “difficult asthma”.

Key messages

  • Recurrent exacerbations

  • High IgE and eosinophils (unless suppressed)

  • Fleeting infiltrates

  • Bronchiectasis in asthma

  • Avoid long-term steroids — consider antifungals/biologics

Who to target

Severe asthma centres, immunology, GPs.

3️⃣ Aspergillus Bronchitis

Purpose

Get clinicians to recognise this exists; most don’t.

Key messages

  • Chronic cough with fungal growth

  • Bronchiectasis or airway damage common

  • Often mistaken for infection or COPD flare

  • Antifungal therapy improves outcomes

  • Not invasive — but not benign either

Who to target

Bronchiectasis clinics, CF care analogies, airway disease MDTs.

4️⃣ SAFS (Severe Asthma with Fungal Sensitisation)

Purpose

Improve allergy and asthma pathways.

Key messages

  • Fungal sensitisation = higher attacks, worse control

  • Consider antifungals in selected cases

  • Not the same as ABPA

Who to target

Allergy and respiratory teams.

🎯 Combine them into audiences — not diseases

Instead of organising by disease, think audience pathways.
This creates more impact.

Example audience pathways:

  • GPs: High-level “think fungal” tools + simple referral rules

  • Respiratory consultants: CPA & ABPA deep-dive campaigns

  • Radiologists: CPA imaging campaign

  • TB services: “Post-TB lung disease – look for CPA” campaign

  • Bronchiectasis MDTs: Aspergillus bronchitis + CPA

  • Severe asthma hubs: ABPA + SAFS + biologics education

  • International LMIC doctors: TB + cavities + CPA focus

Each pathway gets:

  • 1-page factsheet

  • Slide deck

  • Quick referral checklist

  • Patient story

  • Short LinkedIn/text assets

  • Downloadable PDF for clinics

  • Optional webinar / YouTube segment

👥 Where the patient group fits perfectly

Your patient volunteers can help with:

1. Co-production

  • Narratives (“My diagnosis was missed for 6 years”)

  • Quotes on misdiagnosis

  • Descriptions of symptoms to help GPs recognise patterns

2. Short explainer videos

Patients explaining their lived experience are more powerful than any clinical slide.

3. Co-presenting at GP/staff training

Highly effective for ICS-level education.

4. Social media — patient-led messaging

Adds authenticity and reach.

🧭 Recommended Structure of Your Campaign Work

Phase 1 — Establish the umbrella

  • “Chronic Aspergillosis: a hidden epidemic”

  • UK map of inequality

  • NAC role

  • Referral pathways

  • One master slide deck

Phase 2 — Launch 4 micro-campaigns

  • CPA (highest impact)

  • ABPA

  • Aspergillus bronchitis

  • SAFS

Release one per month or quarter.

Phase 3 — Targeted audience campaigns

  • GPs

  • TB

  • COPD

  • Radiology

  • Bronchiectasis

  • Severe asthma

  • International TB/NTM/airway societies

Phase 4 — Ongoing drip-feed

1–2 posts per week
Quarterly webinars
Annual “Aspergillosis Week” or “CPA Month”

🌟 Short answer to your question

YES: You should talk about all forms of aspergillosis — but through a layered strategy: one umbrella campaign + multiple condition-specific campaigns.

This creates:

  • clarity

  • clinical relevance

  • patient engagement

  • sustained visibility

  • actionable behaviour change