Quality and Management of Care to Tuberculosis/Hiv Coinfection in the State of São Paulo, Brazil

Abstract

Objective: to analyze the quality and management of care to tuberculosis/HIV coinfection in the state of São Paulo, Brazil. Methods: a descriptive study involving municipalities having at least five cases of tuberculosis/HIV coinfection in the Brazilian state of São Paulo notified in the tuberculosis notification system. To analyze the quality and management of care to tuberculosis/HIV coinfection, indicators were designed, based on tuberculosis evaluability assessment studies, and validated in Brazil. The municipalities were grouped according to their care quality and then submitted to multiple correspondence analysis. Results: the study formed a group with 18 municipalities (42.86%) with satisfactory care and management quality, and another group with 24 municipalities (57.14%) with a quality characterized as unsatisfactory. In the municipalities that showed a satisfactory result, the investigation identified a low proportion of tuberculosis/HIV coinfection, a low AIDS incidence rate, intermediate population size, and high coverage of the Community Health Workers’ Program and Family Health Strategy. The municipalities with unsatisfactory quality had a high proportion of tuberculosis/HIV coinfection and a high AIDS incidence rate. Conclusion: the study reveals the defining characteristics of quality and management of care to tuberculosis/HIV coinfection as chronic conditions, bringing relevant elements regarding the mobilization of resources and investments in the municipalities where these are necessary. Additionally, the investigation shows that health results are critical where care quality is unsatisfactory, pointing out the need for reorganizing care and the management of actions involving control of tuberculosis/HIV coinfection in these contexts.

Fatores associados ao abandono do tratamento da tuberculose: estudo de casos e controles

“…Em Sapucaia do Sul, houve aumento da incidência de TB em conjunto com a elevação dos casos de coinfecção com HIV/TB, assim como em âmbito nacional, em que foi observada tendência crescente e positiva para a incidência de TB/HIV em diversos estados brasileiros. Em 2016, 8% das pessoas vivendo com HIV apresentavam TB no Brasil, sendo que os indivíduos coinfectados por TB/HIV mostravam alta taxa de abandono (11,6%) e óbito (17,8%) [21][22][23] .…”

Caracterização dos óbitos e dos itinerários terapêuticos investigados pelo Comitê Municipal de Mortalidade por Aids de Porto Alegre em 2015

“…A study carried out in municipalities in the interior region of São Paulo state in 2014 with people with HIV/tuberculosos coinfection, indicated that in places where management of these patients was of a satisfactory quality, Primary Healthcare was better structured and the healthcare network was better organized. 29 The fragile context of the network of health services for people living with HIV/AIDS in Porto Alegre reinforces the need for improvements to HIV care, access to prevention and treatment, as well as improvements to the health service network in general.…”

Tendência temporal da incidência da coinfecção TB/HIV e testagem de HIV da população idosa brasileira de 2008 a 2018

“…On the other hand, a study analyzing the quality and management of care for TB/HIV coinfection in the state of São Paulo showed that in the municipalities where quality was satisfactory there was a low ratio of TB/HIV coinfection, and a low AIDS incidence rate. In the municipalities where quality was unsatisfactory, there was a high ratio of TB/HIV coinfection, and a high AIDS incidence rate 23 .…”