Nutritional risk in patients with pulmonary tuberculosis. A patient or a health services issue?

Objective. To determine nutritional risk factors in a population of patient s with pulmonary tuberculosis (PT). Material and methods. During 1997, one- hundred and eighty-five patients with PT were chosen at random from two hea lth institutions in Monterrey, Nuevo Leon, Mexico. Variables analyzed were: anthropometric measures, socioeconomic status, utilization of the nutritio n clinic, access to foodstuffs, adverse reactions to drugs, and disease att ributable to malnutrition. Statistical analysis consisted of descriptive, b ivariate, and multivariate logistic regression, in addition to prevalence r atios and 95% confidence intervals. Results. The mean age was 42.4+/-19.9 y ears. The mean body mass index was 19.8+/-3.2; 57% of patients presented ma lnutrition; 26% of them were referred to the nutrition clinic, 24.3% of who m actually attended it Multivariate analysis showed that adverse reactions of tuberculosis drugs were risk factors for malnutrition, independent of ag e, gender, education, occupation, year of diagnosis and access to foodstuff s, disease atributable, and utilization of the nutrition ;clinic. (chi(2) = 10.58; P = 0.051, R-2 = 0.42). Conclusions. Nutritional risk in patients w ith pulmonary tuberculosis is both a patient and a health services issue. T he high prevalence of malnutrition, the low utilization rate of nutritional services, and the effect of adverse reactions to therapeutic drugs, justif y the need to focus attention on this particular group of patients.