The Role of Radiological Imaging in Assessing MDR-TB Severity: A Study of CXR Features and Their Association with Socio-Demographic and Clinical Variables.

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 of Study and Duration: Bacha Khan Medical College (BKMC)/Mardan Medical Complex (MMC) MTI, Mardan for one year from 1^st January 2025 to 31^st 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 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.

Conclusion: The incidence of abnormal chest X-ray 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.