Riesgo nutricional en pacientes con tuberculosis pulmonar: ¿cuestión del paciente o de los servicios de salud?

Objective. To determine nutritional risk factors in a populationof patients with pulmonary tuberculosis (PT). Materialand methods. During 1997, one-hundred andeighty-five patients with PT were chosen at random fromtwo health institutions in Monterrey, Nuevo León, México.Variables analyzed were: anthropometric measures, socioeconomicstatus, utilization of the nutrition clinic, access tofoodstuffs, adverse reactions to drugs, and disease attributableto malnutrition. Statistical analysis consisted of descriptive,bivariate, and multivariate logistic regression, inaddition to prevalence ratios and 95% confidence intervals.Results. The mean age was 42.4±19.9 years. The meanbody mass index was 19.8± 3.2; 57% of patients presentedmalnutrition; 26% of them were referred to the nutritionclinic, 24.3% of whom actually attended it. Multivariate analysisshowed that adverse reactions of tuberculosis drugswere risk factors for malnutrition, independent of age, gender,education, occupation, year of diagnosis and access tofoodstuffs, disease atributable, and utilization of the nutritionclinic. (c2=10.58; p=0.051, R2=0.42). Conclusions.Nutritional risk in patients with pulmonary tuberculosis isboth a patient and a health services issue. The high prevalenceof malnutrition, the low utilization rate of nutritionalservices, and the effect of adverse reactions to therapeuticdrugs, justify the need to focus attention on this particulargroup of patients