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. 2023 Jun 8:32:100383.
doi: 10.1016/j.jctube.2023.100383. eCollection 2023 Aug.

Chest X-ray predicts cases of pulmonary tuberculosis among women of reproductive age with acute respiratory symptoms: A multi-center cross-sectional study

Tesfahunegn Hailemariam  1   2 , Getnet Yimer  1   3 , Hussen Mohammed  4 , Haileleul Bisrat  1 , Tigist Ajeme  1 , Merga Belina  1 , Lemessa Oljira  5 , Kedir Teji Roba  6 , Fekadu Belay  7 , Tsion Andrias  8 , Esther Ngadaya  9 , Tsegahun Manyazewal  1
Affiliations

Chest X-ray predicts cases of pulmonary tuberculosis among women of reproductive age with acute respiratory symptoms: A multi-center cross-sectional study

Tesfahunegn Hailemariam et al. J Clin Tuberc Other Mycobact Dis. .

Abstract

Background: Tuberculosis (TB) prevalence is increasing among women of reproductive age (WRA) in sub-Saharan Africa, yet undiagnosed and untreated cases remain rather high with serious health and socio-economic consequences. We aimed to assess the prevalence and predictors of TB in WRA seeking health care for acute respiratory symptoms.

Methods: We consecutively enrolled outpatient WRA with acute respiratory symptoms seeking care at four healthcare facilities in Ethiopia between July 2019 and December 2020. Data on sociodemographic characteristics and clinical information were collected using a structured questionnaire administered by trained nurses. Posteroanterior chest X-ray was performed in non-pregnant WRA and interpreted independently by two radiologists. Sputum samples were collected from all patients and tested for pulmonary TB using Xpert MTB/RIF and/or smear microscopy. Predictors of bacteriologically confirmed TB cases were determined using binary logistic regression, with clinically relevant variables included in the final Firth's multivariate-penalized logistic regression model.

Results: We enrolled 577 participants, of whom 95 (16%) were pregnant, 67 (12%) were living with HIV, 512 (89%) had cough of less than 2 weeks, and 56 (12%) had chest-x-ray findings suggestive of TB. The Overall prevalence of TB was 3% (95% CI: 1.8%-4.7%) with no significant difference observed between patient groups categorized by duration of cough or HIV serostatus (P-value = 0.9999). In multivariable analysis, TB-suggestive CXR abnormality (AOR 18.83 [95% CI, 6.20-57.18]) and history of weight loss (AOR 3.91 [95% CI, 1.25-12.29]) were associated with bacteriologically-confirmed TB cases.

Conclusions: We found a high TB prevalence among low-risk women of reproductive age with acute respiratory symptoms. Routine CXR may improve early case detection and thereby TB treatment outcomes.

Keywords: Acute respiratory symptoms; Chest X-ray; EXIT-TB; Ethiopia; Pulmonary tuberculosis; Women of reproductive age.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

References

    1. Bagcchi S. WHO's Global Tuberculosis Report 2022. The Lancet Microbe. 2023;4(1):e20. - PubMed
    1. Korri R., Bakuli A., Owolabi O.A., Lalashowi J., Azize C., Rassool M., et al. Tuberculosis and Sexual and Reproductive Health of Women in Four African Countries. Int J Environ Res Public Health. 2022;19(22):15103. - PMC - PubMed
    1. Dheresa M., Tura A.K., Daraje G., Abebe M., Dingeta T., Shore H., et al. Trend and determinants of mortality among women of reproductive age: a twelve-year open cohort study in Eastern Ethiopia. Front Global Women's Health. 2021;2 - PMC - PubMed
    1. World Health Organization, Global tuberculosis report 2021: supplementary material. 2022.
    1. World Health Organization, WHO Tuberculosis in women factsheet. 2019.

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