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

Abstract 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 feature...

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Main Authors: Mulat Addis Beshaw, Ekram Mohammed Siraj, Tilahun Bizuayehu Demass, Ayenew Molla Lakew
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-11344-0
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author Mulat Addis Beshaw
Ekram Mohammed Siraj
Tilahun Bizuayehu Demass
Ayenew Molla Lakew
author_facet Mulat Addis Beshaw
Ekram Mohammed Siraj
Tilahun Bizuayehu Demass
Ayenew Molla Lakew
author_sort Mulat Addis Beshaw
collection DOAJ
description Abstract 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/m2 [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.
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spelling doaj-art-653733526333419883d9fbc1cf3516ac2025-08-20T04:01:43ZengBMCBMC Infectious Diseases1471-23342025-08-012511810.1186/s12879-025-11344-0Chest 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 studyMulat Addis Beshaw0Ekram Mohammed Siraj1Tilahun Bizuayehu Demass2Ayenew Molla Lakew3Department of Internal Medicine, College of Medicine and Health Sciences, University of GondarDepartment of Internal Medicine, Alert Comprehensive Specialized HospitalDepartment of Internal Medicine, College of Medicine and Health Sciences, University of GondarDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarAbstract 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/m2 [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.https://doi.org/10.1186/s12879-025-11344-0MDR/RR/DR-TBCXRRadiologic featureFactorsEthiopia
spellingShingle Mulat Addis Beshaw
Ekram Mohammed Siraj
Tilahun Bizuayehu Demass
Ayenew Molla Lakew
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
BMC Infectious Diseases
MDR/RR/DR-TB
CXR
Radiologic feature
Factors
Ethiopia
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic MDR/RR/DR-TB
CXR
Radiologic feature
Factors
Ethiopia
url https://doi.org/10.1186/s12879-025-11344-0
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