Comparison of the Severity of Lung Damage on Chest X-ray Between New Drug-Resistant and Drug-Sensitive Cases of Pulmonary Tuberculosis Patients

Background: Drug-resistant (DR) pulmonary tuberculosis (TB) is often associated with morbidity and mortality compared to drug-susceptible (DS) pulmonary TB. The infectiveness and pathological destruction of DR TB and DS TB strains are still controversial. Objectives: This study aimed to compare the severity of lung damage between new cases of DR and DS pulmonary TB. Methods: This was an analytical observational study with a cross-sectional retrospective design. The sample was selected from the medical records of eligible TB patients treated at RSUD Dr. Soetomo, Surabaya (Indonesia) from January 2018 to November 2022. The severity of lung damage was assessed based on the chest X-ray. Results: A total of 319 patients, consisting of 187 new cases of DS pulmonary TB and 132 new cases of DR pulmonary TB, were recruited. The patients had a mean age of 43.64 years old, and 59.5% of them were male. The most common comorbidity was diabetes mellitus. The severity of DS pulmonary TB was higher in the severe category (77%), while the severity of DR pulmonary TB was higher in the mild-moderate category (51.5%). Conclusions: There was a difference in lung damage on chest X-ray between new cases of DS and DR pulmonary TB. The severity of DS pulmonary TB was higher in the severe category, while the severity of DR pulmonary TB was higher in the mild-moderate category.