OBJECTIVE:To identify areas of vulnerability to new cases of HIV/ tuberculosis (TB) co-infection.

Going to primary health care services for diagnosis increased the time before diagnosis of the disease was reached. The Tuberculosis Control Program clinic was more effective in diagnosis of tuberculosis, due to the training of the staff and to an organized process for receiving patients, including the availability of tests to support the diagnosis.

O vínculo na atenção à saúde: revisão sistematizada na literatura, Brasil (1998-2007)*Bond in health care: a systematic review of literature in Brazil (1998Brazil ( -2007 El vínculo en la atención a la salud: revisión sistematizada en la literatura, Brasil (1998Brasil ( -2007 ABSTRACT Objective:To review the Brazilian scientific literature on bond in health care. Methods: The review was limited to the period from 1998 to 2007. A literature search was conducted in the LILACS and SciELO databases using the following key words: primary health care, acceptance, tuberculosis (indexed), bond, adhesion, health, basic care, continuity, and abandon (not indexed). Initially 50 publications were selected and categorized. Results: The findings suggest a greater interest on the topic after 2004. There was a predominance of publications on primary health care in journals that value community health. Conclusions: Bond was found to be an important factor in primary health care and led to better understanding of the real problems of the population receiving care in those services. In addition, bond facilitated the interactions between clients and health care professionals. Key Words: Primary health care; Scientific and technical publications; Professional-patient relations. RESUMENEl objetivo del estudio fue levantar producciones científicas brasileñas que se relacionaban con la dimensión vínculo en la atención primaria a la salud. El estudio abarcó el período de 1998 a 2007, a partir de las bases de datos LILACS y SciELO por medio de las palabras clave: atención primaria a la salud, acogimiento, tuberculosis (indexados), vínculo, adhesión, salud, atención básica, longitudinal y abandono (no indexados). Fueron seleccionadas 50 producciones que posteriormente fueron categorizadas. Los hallazgos mostraron que hubo un interés mayor por la temática después del año de 2004, predominando publicaciones en periódicos que valorizan la salud colectiva y estudios que se sitúan en el nivel primario de atención. Se entiende que el vínculo es un factor importante para la atención a la salud y tiende a mejorar el conocimiento de los reales problemas de la población atendida por los servicios, además de facilitar la relación de los usuarios con los profesionales que los atienden. Palabras clave: Atención primaria a la salud; Publicaciones científicas y técnicas; Relaciones profesional-paciente.

Atraso na busca por serviço de saúde para o diagnóstico da Tuberculose em Ribeirão Preto (SP)Delay in the search for health services for the diagnosis of tuberculosis in Ribeirao Preto, Sao PauloResumo Foi analisado o atraso na busca por serviço de saúde para o diagnóstico da Tuberculose (TB) em Ribeirão Preto, 2009, em um estudo epidemiológico, transversal, realizado com 94 doentes. Utilizou-se questionário baseado no Primary Care Assessment Tool, adaptado para avaliar a atenção à TB. Estabeleceu-se a mediana (15 dias ou mais) para caracterizar atraso na busca pelo primeiro atendimento. Através da Razão de Prevalência, identificaram-se as variáveis relacionadas ao maior atraso. O primeiro serviço de saúde procurado foi o de pronto atendimento (57,4%). Verificou-se um maior tempo na procura pelos serviços de saúde entre os doentes: do sexo masculino; com idade entre 50 a 59 anos; com renda familiar inferior a cinco salários mí-nimos; forma pulmonar; casos novos; não coinfecção TB/HIV; não consumiam bebida alcoóli-ca, conhecimento satisfatório sobre TB (apresentou significância estatística na associação com o atraso) e que não procuravam o serviço de saúde próximo do domicílio antes de ter TB. Verificouse a necessidade de capacitação para os profissionais de saúde quanto aos sinais e sintomas da doença, reduzindo as barreiras de acesso ao diagnóstico oportuno da TB e divulgação ampla para a comunidade em geral. Palavras-chave Tuberculose, Diagnóstico tardio, Acesso aos serviços de saúde Abstract The scope of this paper is to analyze delays in locating health services for the diagnosis of tuberculosis in Ribeirao Preto in 2009. An epidemiological and cross-sectional study was conducted with 94 TB patients undergoing treatment. A structured questionnaire, based on the Primary Care Assessment Tool adapted for TB care was used. A median (15 days or more) was established to characterize delay in health attendance. Using the Prevalence Ratio, the variables associated with longer delay were identified. The first healthcare services sought were the Emergency Services (ES) (57.5%). The longest period between seeking assistance occurred among males, aged between 50 and 59, who earned less than five minimum wages, had pulmonary TB, were new cases, were not co-infected with TB/HIV, did not consume alcohol, had satisfactory knowledge about TB before diagnosis (with a statistically significant association with delay) and who did not seek healthcare close to home before developing TB. There is a perceived need for training healthcare professionals about the signs and symptoms of the disease, reducing barriers of access to timely diagnosis of TB and widely disseminating it to the community in general.

Objective: Analyze the actions developed in Primary Health Care (PHC) to promote adherence to tuberculosis (TB) treatment in the perception of patients and nursing team. Methods: Cross-sectional epidemiological study conducted at the PHC of Campinas-SP, through structured interviews with 18 corresponding questions on the perception of professionals (183) and patients (165). Chi-square test and Fisher's exact test were used. Results: Actions such as the promotion of autonomy and time for the patient to talk about doubts and concerns, guidance to seek information in books and/or on the Internet on the disease, and for the family to perform TB tests, undergo directly observed treatment, schedule monthly consultations, delivery of written information on treatment and incentive were actions more perceived by the professionals than patients reported receiving. Conclusions: The identification of gaps in the offer of actions for adherence to TB treatment can help health services to change and improve the practice and the epidemiological scenario of the disease.

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delay in seeking care was lower among smokers and alcohol users; shortcomings in access to diagnosis characterized health services delay.

Objective: to analyze the offering of health actions and services for the control of tuberculosis for people living with HIV/AIDS being followed up in the Specialized Care Services for HIV/AIDS in Ribeirão Preto, SP, Brazil. Method: quantitative, exploratory survey study. Participated 253 people living with HIV/AIDS followed up by this service, considering as inclusion criteria: individuals older than 18 years living in the city and not inmates. Data collection was conducted from January 2012 to May 2013 through interviews with the support of a specific instrument. Data were analyzed using indicators and a composite index. Results: the offering of services for the control of tuberculosis in people living with HIV/AIDS by municipal services was considered as intermediate, reinforcing the need for better planning for comprehensive assistance, coordination of professionals in teams and among the services network, in addition to professional training and continuing education. Conclusion: it is necessary to implement strategies that promote shared actions between TB and HIV / AIDS programs and between different services in order to strengthen the local care network, aimed at producing an individualized care, comprehensive and responsive.