title: Factors associated with pulmonary tuberculosis among patients seeking medical attention at referral clinics for tuberculosis.
abstract: OBJECTIVE
  The identification of behavioral and clinical factors that are associated with pulmonary tuberculosis might improve the detection and treatment of the disease, thereby reducing its duration and transmission. Our objective was to identify sociodemographic, clinical, and behavioral factors that are associated with the diagnosis of pulmonary tuberculosis.
  
  
  METHODS
  This was a cross-sectional study conducted between April of 2008 and March of 2009 at three health care clinics in the city of Fortaleza, Brazil. We selected 233 patients older than 14 years of age who spontaneously sought medical attention and presented with cough for > 2 weeks. Sociodemographic, clinical, and behavioral data were collected. Sputum smear microscopy for AFB and mycobacterial culture were also carried out, as were tuberculin skin tests and chest X-rays. The patients were divided into two groups (with and without pulmonary tuberculosis). The categorical variables were compared by the chi-square test, followed by logistic regression analysis when the variables were considered significant.
  
  
  RESULTS
  The prevalence of pulmonary tuberculosis was 41.2%. The unadjusted OR showed that the following variables were statistically significant risk factors for pulmonary tuberculosis: fever (OR = 2.39; 95% CI, 1.34-4.30), anorexia (OR = 3.69; 95% CI, 2.03-6.75), and weight loss (OR = 3.37; 95% CI, 1.76-6.62). In the multivariate analysis, only weight loss (OR = 3.31; 95% CI, 1.78-6.14) was significantly associated with pulmonary tuberculosis.
  
  
  CONCLUSIONS
  In areas with a high prevalence of tuberculosis, weight loss could be used as an indicator of pulmonary tuberculosis in patients with chronic cough for > 2 weeks.
authors.affiliation: Department of Community Health, Federal University of Ceará School of Medicine, Fortaleza, Brazil.
authors.forename: Cid Carlos Soares de
authors.initials: CC
authors.lastname: Alcântara
authors.forename: Afrânio Lineu
authors.initials: AL
authors.lastname: Kritski
authors.forename: Valéria Goes
authors.initials: VG
authors.lastname: Ferreira
authors.forename: Mônica Cardoso
authors.initials: MC
authors.lastname: Façanha
authors.forename: Ricardo Soares
authors.initials: RS
authors.lastname: Pontes
authors.forename: Rosa Salani
authors.initials: RS
authors.lastname: Mota
authors.forename: Terezinha do Menino Jesus Silva
authors.initials: Tdo M
authors.lastname: Leitão
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D015431:Weight Loss