• ISSN(Print): 2789-4355
    ISSN(Online): 2958-0358
  • editor.hmdj@hitec-ims.edu.pk
    051- 4908582
  • HITEC-IMS, HIT, Taxila Cantt,
    Punjab, Pakistan
  • Submit Manuscript
HITEC Medical & Dental Journal (HMDJ) Submit Manuscript
The Role Of Radiological Imaging In Assessing MDR-TB Severity: A Study Of CXR Features And Their Association With Socio-Demographic And Clinical Variables

Authors

Sajjad Ali
Associate Professor. Department of Pulmonology, Mardan Medical Complex.
Laila Khan
Assistant Professor. Department of Radiology, Mardan Medical Complex.
Rumman
Pharmacovigilance Officer, Medical Teaching Institution Mardan Medical Complex, Mardan Medical Complex.
Aleina Ali Shah
Program Manager MDR Tb, Association for Community Development KP, Mardan Medical Complex.
Akmal Naveed
Director Association for Community Development KP, Mardan Medical Complex.
Umair Zaman
Registrar Medical Teaching Institution, Mardan Medical Complex.

Abstract

Objective:
To assess chest X-ray patterns in multidrug-resistant tuberculosis (MDR-TB) patients and determine their association with socio-demographic and clinical characteristics.
Study Design:
Cross sectional, analytical study.
Place and Duration of Study:
Bacha Khan Medical College (BKMC)/Mardan Medical Complex (MMC) MTI, Mardan, 01year(From January 2025 to December 2025).
Patients and Methods:
A total of 147 confirmed MDR-TB patients, aged ≥18 years, were enrolled through consecutive sampling. A structured proforma was used to gather data, related to socio-demographic profile, clinical characteristics, and behavioral factors. Chest X-ray (CXR) patterns were classified as abnormal (cavitation, consolidation, pleural effusion, infiltration) or normal. SPSS version 26 was used to analyze the data. Descriptive statistics were calculated and associations were evaluated by Chi-square test and multivariable logistic regression.
Results:
The incidence of abnormal CXR findings was 74.8% of 147 patients. Infiltrations and cavitations were the most prevalent abnormalities, found radiologically. The percentage of abnormal CXR results was higher in the patients with low BMI (47.6%), anemia (51.7%) and comorbidities (19.7%). Significant associations were found between abnormal CXR findings and BMI (p = 0.046), comorbidities (p = 0.001), daily labor occupation (p = 0.014), and HIV status (p = 0.021).
Conclusion:
The prevalence of abnormal chest X-ray findings among MDR-TB patients is high and related to poor nutritional status, anemia, comorbid conditions and immunosuppression. The chest X-ray is useful and cost effective for use to determine disease severity in a resource-limited community context.
Kewords:
Anemia; Chest X-ray; Comorbidity; Multidrug-resistant tuberculosis

How to cite this article

Khan L, Ali S, Rumman, Shah AA, Naveed A, Zaman U. The Role of Radiological Imaging in Assessing MDR-TB Severity: A Study of CXR Features and Their Association with Socio-Demographic and Clinical Variables. HMDJ. 2026 June; 06(01):18-25.
DOI: https://doi.org/10.69884/hmdj.6.1.3018

References

  1. Xi Y, Zhang W, Qiao RJ, Tang J. Risk factors for multidrug-resistant tuberculosis: a worldwide systematic review and meta-analysis. PLoS One. 2022;17(6):e0270003. doi:10.1371/journal.pone.0270003.
  2. Lv H, Zhang X, Zhang X, Bai J, You S, Li X, et al. Global prevalence and burden of multidrug-resistant tuberculosis from 1990 to 2019. BMC Infect Dis. 2024;24(1):243. doi:10.1186/s12879-024-09079-5.
  3. Li S, Mensah E, Liu M, Pan L, Lu W, Zhou S, et al. The burden of tuberculosis and drug resistance in 22 Sub-Saharan African countries, 1990-2021: a GBD 2021 analysis and progress towards WHO 2035 targets with projections to 2050. Front Microbiol. 2025;16:1695592. doi:10.3389/fmicb.2025.1695592.
  4. Khan MA, Bilal W, Asim H, Rahmat ZS, Essar MY, Ahmad S. MDR-TB in Pakistan: challenges, efforts, and recommendations. Ann Med Surg (Lond). 2022;79:104009. doi:10.1016/j.amsu.2022.104009.
  5. Thin NT, Hlaing T, Soe PP. Key drivers of high TB burden in top 10 countries: a systematic review. Health Inform Int J. 2025;9(1):1-12.
  6. Zhang F, Han H, Li M, Tian T, Zhang G, Yang Z, et al. Revolutionizing diagnosis of pulmonary Mycobacterium tuberculosis based on CT: a systematic review of imaging analysis through deep learning. Front Microbiol. 2025;15:1510026. doi:10.3389/fmicb.2024.1510026.
  7. Rayan AM, Adam A, Al-Arabi G, Ahmed MR. The applications of X-ray technology in medical imaging: advances, challenges, and future perspectives. J Sustain Food Water Energy Environ. 2025;1(2):39-61.
  8. Liu B, Liu L, Li L, Li G, Liu Y. Pulmonary tuberculosis. In: Li H, Liu J, Li L, editors. Radiology of infectious and inflammatory diseases. Singapore: Springer; 2023. p. 315-34. doi:10.1007/978-981-99-4614-3_16.
  9. Fahrezi AI, Irsandy F, Azka H. Clinical characteristics and radiological features of multi-drug-resistant pulmonary TB patients. J Edu Health. 2024;15(3):126-37. doi:10.54209/eduhealth.v15i03.
  10. Patil S, Choudhari S, Dahiphale J, Narkar S, Raka V, et al. Cavitating consolidation with acute febrile respiratory illness and “sister cavities” without typical constitutional symptoms in pulmonary tuberculosis: a rare but possible presentation. South Asian Res J Med Sci. 2023;5(2):41-52. doi:10.36346/sarjms.2023.v05i02.006.
  11. Jawad N, Jafri S, Saifullah N, Ahmed N. The cavity as a lasting abode for tuberculous bacilli: an observational study. SN Compr Clin Med. 2022;4(1):40. doi:10.1007/s42399-021-01098-6.
  12. Nel M, Franckling-Smith Z, Pillay T, Andronikou S, Zar HJ. Chest imaging for pulmonary TB-an update. Pathogens. 2022;11(2):161. doi:10.3390/pathogens11020161.
  13. Patel B, Kumar R, Ramesh V. TB and other chest infections. Lung India. 2022;39(Suppl):S43-85. doi:10.4103/0970-2113.341105.
  14. Xu CJ, Lu PX, Li CH, He YL, Fang WJ, Xie RM, et al. Chinese expert consensus on imaging diagnosis of drug-resistant pulmonary tuberculosis. Quant Imaging Med Surg. 2024;14(1):1039-60. doi:10.21037/qims-23-1223.
  15. Rai DK, Kumar A. Clinico-demographic characteristics of multidrugresistant pulmonary tuberculosis presenting to tertiary care hospital of India. J Assoc Chest Physicians. 2020;8(1):14-8. doi:10.4103/jacp.jacp_14_18.
  16. Ahmad A, Rehman HU, Rashid F, Zainab S, Saeed M, Khan TA. Correlation between chest radiographic features and time to culture conversion in patients co-infected with multidrug-resistant tuberculosis and HIV in Khyber Pakhtunkhwa. Pak J Chest Med. 2023;29(1):83-8.
  17. Zaidi SMA, Creswell J, Khowaja S, Khan A, Copas A, Esmail H. Detection of pulmonary tuberculosis through mobile X-ray based active case-finding in Pakistan: a retrospective analysis from programmatic screening of 1 214 289 individuals from 2017 to 2021. BMJ Glob Health. 2025;10(7):e019133. doi:10.1136/bmjgh-2025-019133.
  18. Saqib HA, Saeed U, Awan MM, Firdous A, ul Islam Z. Atypical radiological presentations of pulmonary tuberculosis: an analysis of associated factors. Pak J Chest Med. 2023;29(4):501-10.
  19. Khattak M, Farooq M, Kazmi SK, Saeed M, Sheikh MU, Shuaib M. Correlation between chest radiographic findings, sputum bacterial load, and treatment outcomes in extensively drug-resistant tuberculosis patients. Pak J Chest Med. 2022;28(3):371-7.
  20. Dholakia YN, D'Souza DT, Tolani MP, Chatterjee A, Mistry NF. Chest X-rays and associated clinical parameters in pulmonary tuberculosis cases from the National Tuberculosis Programme, Mumbai. Infect Dis Rep. 2012;4(1):e10. doi:10.4081/idr.2012.e10.
  21. Meghji J, Simpson H, Squire SB, Mortimer K. A systematic review of the prevalence and pattern of imaging defined post-TB lung disease. PLoS One. 2016;11(8):e0161176. doi:10.1371/journal.pone.0161176.
  22. Feyisa DW, Ayano YM, Debelee TG, Schwenker F. Weak localization of radiographic manifestations in pulmonary tuberculosis from chest X-ray: a systematic review. Sensors (Basel). 2023;23(15):6781. doi:10.3390/s23156781.

All Volumes

Full Text PDF
HMDJ © 2023 All Right Reserved || Powered By IT Department