O controle da tuberculose na perspectiva da Vigilância da Saúde

Abstract

Considerando que o referencial teórico da Vigilância da Saúde (VS) pode constituir um importante modelo para monitoramento da situação de saúde, este estudo reflexivo tem por objetivo discutir as possibilidades de contribuição no controle da Tuberculose. Com base em estudos anteriores de grande escala, a discussão aponta que a identificação de áreas heterogêneas de risco pode fornecer subsídios para a escolha das intervenções direcionadas para as necessidades de grupos mais vulneráveis, contribuindo, assim, para diminuir as iniquidades em saúde. A VS utilizada na Estratégia de Saúde da Família torna-se um profícuo meio de transformar os processos de trabalho em saúde, ao propiciar a compreensão ampliada do objeto da atenção e estimular intervenções nos determinantes da Tuberculose.

Estrutura, organização e processos de trabalho no controle da tuberculose em municípios do estado do Rio de Janeiro, RJ, Brasil

“…Embora não tenham sido destacadas no roteiro das entrevistas, as ações intersetoriais têm a sua importância reconhecida para o controle da TB, tendo em vista os inúmeros determinantes sociais, econômicos e culturais associados ao risco de infecção e adoecimento, assim como ao prognóstico de indivíduos doentes 15 . Este achado pode ser indicativo da preponderância ainda vigente do modelo tradicional de controle da TB, centralizado e vertical, em detrimento da concepção do modelo assistencial da vigilância da saúde, calcado no atributo da integralidade da atenção e na descentralização dos serviços de saúde.…”

“…A implantação do SUS tornou premente a descentralização, e a expansão da ESF, apoiada na perspectiva da vigilância da saúde, pode ajudar a superar esse desafio 15 . A incorporação das ações de controle da TB pelas equipes da ESF encerra um grande potencial de ampliação da sensibilidade do PCT, em especial, para identificação de casos bacilíferos.…”

Discourses of healthcare professionals about health surveillance actions for Tuberculosis control

“…It contributes to TB control when it seeks to transform and enable the work processes in health, transcending the health services spaces, using territorialities as an instrument to recognize where the population lives and works. In this regard, HS proposes an expanded understanding of the population's health care and stimulates interventions in the determinants of TB (6) . HS actions can contribute to the control of the disease, considering the work of the team of healthcare professionals is done according to each local reality, as health professionals are inserted in the community and carry out activities with the population, such as health education, searches for respiratory symptoms, observation of medication intake, monitoring of contacts, searching for absentees, among other actions that leave the individual scope and become collective, thus generating an improvement in the access to health services, diagnosis and treatment of TB patients (6)(7) .…”

“…In this regard, HS proposes an expanded understanding of the population's health care and stimulates interventions in the determinants of TB (6) . HS actions can contribute to the control of the disease, considering the work of the team of healthcare professionals is done according to each local reality, as health professionals are inserted in the community and carry out activities with the population, such as health education, searches for respiratory symptoms, observation of medication intake, monitoring of contacts, searching for absentees, among other actions that leave the individual scope and become collective, thus generating an improvement in the access to health services, diagnosis and treatment of TB patients (6)(7) . Therefore, it is important to explore the meanings produced by professionals about the actions of HS performed in a country with high TB burden, since the comprehension of these meanings can contribute to the elaboration of strategies that involve the local conditions for the production of TB control and to the use of new disease control practices in Mozambique and in countries with similar characteristics.…”

Deaths by tuberculosis in a priority city for disease control in the Brazilian Northeast: sociodemographic-operational characteristics and vulnerable territories.

“…Health surveillance is an important model for the territorial monitoring of the health situation; that is so because it is in the geographical space where people produce and reproduce socially that the needs and health problems should be captured and the intervention priorities should be defined [4]. The integration of health surveillance and care, information and action should be considered the target of best practices in health care, so that TB surveillance is truly capable of knowing and identifying the cases, hospitalizations and deaths and their locations, in order to guide the control actions with a view to interrupting the transmission chain and assessing the result of these actions [5].…”