Implantação da estratégia DOTS no controle da Tuberculose na Paraíba: entre o compromisso político e o envolvimento das equipes do programa saúde da família (1999)(2000)(2001)(2002)(2003)(2004) Implementation of the DOTS strategy in the control of TB in Paraiba: between the political commitment and the involvement of the teams of the family health program (1999)(2000)(2001)(2002)(2003)(2004) Resumo Foi analisada a implantação da estraté-gia Tratamento Diretamente Observado de Curta Duração (DOTS) no controle da tuberculose, sob a ótica dos coordenadores do Programa de Controle da Tuberculose (PCT), nos seis municípios prioritários da Paraíba. Foram realizadas entrevistas semiestruturadas com sete coordenadores de PCT. Fortalezas do DOTS: cinco municípios alcançaram a taxa de cura de 90%. Entre as debilidades identificou-se, na dimensão política, a descontinuidade do cargo de coordenador de PCT, o despreparo da equipe local, a precariedade da estrutura técnico-administrativa e a insuficiência da rede laboratorial; na dimensão operacional ainda é baixa a incorporação da busca de sintomáti-cos respiratórios pelas Equipes de Saúde da Famí-lia. Ocorreram mudanças de cunho epidemioló-gico, operacional e político. a implantação e garantia da sustentabilidade do DOTS no Estado dependem do modo da organização dos serviços de saúde e o compromisso político do gestor no apoio a estratégia. Palavras-chave Tuberculose, Terapia Diretamente Observada, Saúde da Família, Sistemas de Saúde Abstract The scope of this paper is to analyze the implementation of the Directly Observed Treatment Short-Course (DOTS) strategy in the control of tuberculosis, from the standpoint of the coordinators of the Tuberculosis Control Program (TCP) in six priority municipalities in the state of Paraíba, Brazil. Semi-structured interviews were conducted with seven TCP coordinators. Five municipalities proved to be DOTS success points achieving a 90% cure rate. Among the DOTS weak points in the political dimension, the following aspects were identified: lack of continuity of the TCP coordinator position; lack of preparedness of the local team; precarious technicaladministration structure and insufficiency of the laboratory network. In the operational dimension, the search for respiratory symptoms by the Family Health Teams is still low. Changes of an epidemiological, operational and political nature have been incorporated, though the implementation and guarantee of the sustainability of DOTS in the State depends on the way the health services are organized and on the manager's political commitment to support the strategy.
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