Factors Associated with Abnormal Chest Radiographic Findings in Tuberculosis Screening among High-Risk Groups, Waeng Noi Hospital, Khon Kaen Province, Fiscal Years 2023–2025

Abstract

This study employed a cross-sectional analytical study, collecting secondary data from the TB registry and patient medical records. The study population comprised 3,916 individuals from seven tuberculosis high-risk groups, as defined by the Department of Disease Control, who underwent chest radiographic (CXR) screening. Data were analyzed using descriptive statistics, Chi-square test, Fisher's exact test, and Binary Logistic Regression, with results reported as adjusted odds ratio (AOR) at a statistical significance level of p < 0.05. The majority of participants were female (56.5%), with a mean age of 59.2 years (SD = 15.0). Most were engaged in agricultural occupations (80.2%), and the predominant risk group was household and close contacts of TB cases (64.0%). Abnormal CXR findings were identified in 26 cases, yielding a prevalence of 0.66%, with fiscal year 2023 recording the highest annual rate at 1.23%. Among those with abnormal CXR, 73.1% were confirmed as having pulmonary tuberculosis, and 26.9% had non-TB pulmonary lesions. Regarding factors associated with abnormal CXR findings, age was significantly associated with abnormal CXR results (p = 0.01). Individuals aged ≥60 years had an adjusted odds ratio of abnormal CXR of 4.00 times that of those aged <60 years (AOR = 4.00; 95% CI: 1.29–12.50). Recommendations: High-efficiency CXR-based TB screening among high-risk groups should be sustained and strengthened. Intensified screening should be prioritized for males aged ≥60 years and household contacts of TB cases. Furthermore, implementing intensified screening protocols and considering the adoption of AI-assisted computer-aided detection (CAD) systems are recommended to reduce diagnostic delay in community hospital settings.