Chest X-Ray Comparison Between Drug-Resistant and Drug-Sensitive Pulmonary Tuberculosis in Children

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM Clinical Respiratory Journal Pub Date : 2024-09-25 DOI:10.1111/crj.70010

Saffanah Az Zuhriyyah, Harry Galuh Nugraha, Djatnika Setiabudi, Prayudi Santoso, Heda Melinda Nataprawira

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Abstract

Introduction

Chest X-ray (CXR) remains one of the tools used in diagnosing tuberculosis (TB). However, few studies about such tools exist, specifically in children in Indonesia. We aim to investigate and compare the CXR findings of children with pulmonary drug-resistant TB (DR-TB) and drug-sensitive TB (DS-TB) that could help in the evaluation and management of TB cases in children.

Methods

Retrospective analysis with cross-sectional approach was conducted in children (<18 years old) diagnosed with pulmonary DR-TB and DS-TB from January 2018 to December 2021. Documented data were collected from the Paediatric Respirology Registry and Tuberculosis Information System at Dr. Hasan Sadikin General Hospital Bandung. Characteristics of children, CXR findings, and TB severity were assessed and compared using the chi-square and Fisher's exact tests with significance levels set at p value <0.05.

Results

Sixty-nine children (DR-TB 31 children vs. DS-TB 38 children) were assessed. Of the 31 children with DR-TB, 65% were classified as multidrug-resistant TB (MDR-TB), followed by rifampicin-resistant TB (RR-TB), pre-extensively drug-resistant TB (pre-XDR-TB), and extensively drug-resistant TB (XDR-TB). The most common CXR findings in DR-TB are consolidation (68%), fibrosis (42%), and cavity (29%), whereas in DS-TB, it is pleura effusion (37%). Severe TB accounts for 50% of DR-TB (p = 0.008).

Conclusions

Consolidation, fibrosis, cavities, and findings of severe TB are most common in DR-TB. Pleural effusion is the most common in DS-TB. These findings have the potential to be considered in further examination of children with pulmonary DR-TB and DS-TB; hence, more extensive studies are needed to confirm these results.

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儿童耐药性肺结核与药物敏感性肺结核胸部 X 光片比较

导言胸部 X 光（CXR）仍然是诊断肺结核（TB）的工具之一。然而，有关此类工具的研究很少，尤其是针对印度尼西亚儿童的研究。我们旨在调查和比较耐药肺结核（DR-TB）和药敏肺结核（DS-TB）患儿的胸部 X 光检查结果，以帮助评估和管理儿童肺结核病例。方法对 2018 年 1 月至 2021 年 12 月期间诊断为肺部 DR-TB 和 DS-TB 的儿童（<18 岁）进行横断面回顾性分析。记录数据来自万隆哈桑-萨迪金博士综合医院的儿科呼吸内科登记处和结核病信息系统。采用卡方检验（chi-square）和费雪精确检验（Fisher's exact）对儿童特征、CXR结果和结核病严重程度进行评估和比较，显著性水平设定为P值<0.05。结果共评估了 69 名儿童（DR-TB 31 名，DS-TB 38 名）。在31名DR-TB患儿中，65%被归类为耐多药结核病（MDR-TB），其次是耐利福平结核病（RR-TB）、前广泛耐药结核病（pre-XDR-TB）和广泛耐药结核病（XDR-TB）。在 DR-TB 中，最常见的 CXR 检查结果是合并症（68%）、纤维化（42%）和空洞（29%），而在 DS-TB 中则是胸腔积液（37%）。重症肺结核占 DR-TB 的 50%（P = 0.008）。结论合并、纤维化、空洞和重症肺结核在 DR-TB 中最为常见。胸腔积液在 DS-TB 中最为常见。在对肺部 DR-TB 和 DS-TB 儿童进行进一步检查时，有可能会考虑到这些结果；因此，需要进行更广泛的研究来证实这些结果。

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来源期刊

Clinical Respiratory Journal 医学-呼吸系统

CiteScore

3.70

自引率

0.00%

发文量

104

审稿时长

>12 weeks

期刊介绍： Overview Effective with the 2016 volume, this journal will be published in an online-only format. Aims and Scope The Clinical Respiratory Journal (CRJ) provides a forum for clinical research in all areas of respiratory medicine from clinical lung disease to basic research relevant to the clinic. We publish original research, review articles, case studies, editorials and book reviews in all areas of clinical lung disease including: Asthma Allergy COPD Non-invasive ventilation Sleep related breathing disorders Interstitial lung diseases Lung cancer Clinical genetics Rhinitis Airway and lung infection Epidemiology Pediatrics CRJ provides a fast-track service for selected Phase II and Phase III trial studies. Keywords Clinical Respiratory Journal, respiratory, pulmonary, medicine, clinical, lung disease, Abstracting and Indexing Information Academic Search (EBSCO Publishing) Academic Search Alumni Edition (EBSCO Publishing) Embase (Elsevier) Health & Medical Collection (ProQuest) Health Research Premium Collection (ProQuest) HEED: Health Economic Evaluations Database (Wiley-Blackwell) Hospital Premium Collection (ProQuest) Journal Citation Reports/Science Edition (Clarivate Analytics) MEDLINE/PubMed (NLM) ProQuest Central (ProQuest) Science Citation Index Expanded (Clarivate Analytics) SCOPUS (Elsevier)