Chest x-ray features and their associated factors among rifampicin/multi-drug-resistant tuberculosis patients in drug-resistant tuberculosis treatment initiating centers in Addis Ababa, Ethiopia: a retrospective study.

INTRODUCTION

Rifampicin/multi-drug resistant tuberculosis (RR/MDR-TB) treatment regimen selection and its treatment duration are significantly influenced by the degree of lung damage identified with baseline chest x-rays (CXR). Hence, this study was aimed at determining baseline CXR features and their associated factors in Addis Ababa, Ethiopia.

METHODS

The data was collected from 324 RR/MDR-TB patients who had baseline chest x-rays. The data was collected using a structured checklist containing socio-demographics, baseline chest x-rays, and other clinical variables. It was entered into Epi Data 4.1 and then exported to SPSS version 25 for data cleaning and analysis. A binary logistic regression model was fitted. Bivariate logistic regression was done first, then variables with a p-value ≤ 0.2 were taken into the multivariable logistic regression analysis. Variables with a p-value < 0.05 were reported as statistically significant.

RESULTS

Of the 324 study participants, nearly 74% (239) of them had abnormal baseline CXR features. The most common abnormal CXR feature was cavitation, followed by consolidation. In RR/MDR-TB patients with malnutrition, anemia, and any previous TB treatment history, the most common abnormal radiologic feature was cavitation. Daily laborer [AOR = 0.1 (95% CI: 0.01, 0.55)], BMI < 18.5 kg/m [AOR = 1.8 (95% CI: 1.02, 3.17)], HIV-positive [AOR = 0.41 (95% CI: 0.2, 0.86)], and comorbidities [AOR = 0.32 (95% CI: 0.15, 0.67)] were significantly associated with abnormal CXR features in RR/MDR-TB patients.

CONCLUSIONS AND RECOMMENDATIONS

In our study, the majority of RR/MDR-TB patients had abnormal CXR features, of which cavitation was the most common. Therefore, further study needs to be done prospectively at the multi-center level since the extent of lung damage identified by CXR is one of the determining factors for DR-TB treatment regimen selection, DR-TB treatment duration, help diagnose DR-TB clinically, and TB sequelae.