Beshaw Mulat Addis, Siraj Ekram Mohammed, Demass Tilahun Bizuayehu, Lakew Ayenew Molla
Department of Internal Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Internal Medicine, Alert Comprehensive Specialized Hospital, Addis Ababa, Ethiopia.
BMC Infect Dis. 2025 Aug 2;25(1):974. doi: 10.1186/s12879-025-11344-0.
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.
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.
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.
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.
利福平/耐多药结核病（RR/MDR-TB）治疗方案的选择及其治疗时长受到基线胸部X光片（CXR）所确定的肺部损伤程度的显著影响。因此，本研究旨在确定埃塞俄比亚亚的斯亚贝巴的基线胸部X光片特征及其相关因素。
数据收集自324例有基线胸部X光片的RR/MDR-TB患者。使用包含社会人口统计学、基线胸部X光片及其他临床变量的结构化检查表收集数据。数据录入Epi Data 4.1，然后导出至SPSS 25版本进行数据清理和分析。拟合二元逻辑回归模型。首先进行双变量逻辑回归，然后将p值≤0.2的变量纳入多变量逻辑回归分析。p值<0.05的变量被报告为具有统计学意义。
在324名研究参与者中，近74%（239名）有异常的基线胸部X光片特征。最常见的异常胸部X光片特征是空洞形成，其次是实变。在伴有营养不良、贫血和既往有任何结核病治疗史的RR/MDR-TB患者中，最常见的异常放射学特征是空洞形成。体力劳动者[AOR = 0.1（95%CI：0.01，0.55）]、BMI<18.5 kg/m²[AOR = 1.8（95%CI：1.02，3.17）]、HIV阳性[AOR = 0.41（95%CI：0.2，0.86）]以及合并症[AOR = 0.32（95%CI：0.15，0.67）]与RR/MDR-TB患者的异常胸部X光片特征显著相关。
在我们的研究中，大多数RR/MDR-TB患者有异常的胸部X光片特征，其中空洞形成最为常见。因此，鉴于胸部X光片所确定的肺部损伤程度是耐多药结核病治疗方案选择、耐多药结核病治疗时长、临床诊断耐多药结核病以及结核病后遗症的决定因素之一，需要在多中心层面进行前瞻性进一步研究。
