A porta de entrada para o diagnóstico da tuberculose no sistema de saúde de Ribeirão Preto/SP

Oliveira, Mayra Fernanda de; Arcêncio, Ricardo Alexandre; Ruffino-Netto, Antônio; Scatena, Lúcia Marina; Palha, Pedro Fredemir; Villa, Tereza Cristina Scatena

doi:10.1590/s0080-62342011000400015

Cited by 34 publications

(42 citation statements)

References 11 publications

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“…The literature indicates that the PHC and EC services are the most sought when the symptoms of TB start to appear; however, the hospital system and the private health services are also a gateway for diagnosis of the disease, as some offer direct access to a medical consultation and/or an EC service (5)(6)20) . In this regard, it stands out that this reality was also found in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…The difficulties impeding the achievement of efficient detection of cases of TB are more related to how the health services are organized for detecting and treating cases of TB than to the means of diagnosis per se (4) .The multiple factors which lead to delay in the illness's diagnosis and care reflect the complexity of TB control, as they perform an important role, both in aspects intrinsic to the TB patient -which involve the meaning of being ill and the perception of the signs and symptoms -and in access to the health services and to the care received in these places (5)(6) .…”

Section: Introductionmentioning

confidence: 99%

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Early diagnosis of tuberculosis in the health services in different regions of Brazil

Villa

Ponce

Wysocki³

et al. 2013

Rev. Latino-Am. Enfermagem

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Objective: To analyze the infected person's first contact with the health services, for the early diagnosis of tuberculosis (TB) in different regions of Brazil. Method: a cross-sectional study undertaken in 6 municipalities in the South-east, South and North-east regions of Brazil. Data collection involved secondary sources and interviews with the patients. The data was analyzed using descriptive techniques and multiple correspondence factor analysis. Results: Primary Health Care (PHC) presented the longest time to diagnosis and the lowest proportion of diagnoses. The services associated with diagnosis in the first consultation were the specialized services and the Tuberculosis Control Programs, which offer consultations and tests on-site. Conclusion: For the control of TB, it is necessary to organize the work in an integrated way between the different services' teams. In Primary Health Care, it is also necessary to observe the extent of incorporation and sustainability in the implementation of these actions into the health services' daily practice. a Atenção Primária à Saúde apresentou maior tempo e menor proporção de diagnósticos. Os serviços associados ao diagnóstico, na primeira consulta, foram os serviços especializados e os Programas de Controle da TB, que oferecem consulta e exames no próprio local. Conclusão:faz-se necessária a organização do trabalho de forma integrada, entre as equipes dos diferentes serviços, para as ações de controle da TB. Na Atenção Primária à Saúde, é preciso ainda observar o grau de incorporação e sustentabilidade na execução dessas ações à prática diária dos serviços.Descritores: Tuberculose; Diagnóstico; Avaliação de Serviços de Saúde; Atenção Primária à Saúde. El diagnóstico oportuno de la tuberculosis en los servicios de salud de varias regiones de BrasilObjetivo: Analizar el primer contacto del paciente con los servicios de salud para el diagnóstico oportuno de la tuberculosis (TB) en diferentes regiones de Brasil. Método: Estudio transversal en seis ciudades en el sudeste, sur y noreste. La recolección de datos utilizó fuentes secundarias y entrevistas con los pacientes. Los datos fueron analizados utilizando técnicas descriptivas y el análisis factorial de correspondencias múltiples. Resultados: La Atención Primaria obtuve menor proporción de diagnósticos y mayor tiempo. Los servicios asociados con el diagnóstico en la primera visita fueron los servicios especializados y los Programas de Control de la Tuberculosis, que ofrecen consultas y exámenes in situ. Conclusión: Es necesaria la organización del trabajo integrado entre los equipos de los diferentes servicios para las acciones de control. En la Atención Primaria, es necesario también observar el grado de desarrollo y sostenibilidad en la aplicación de estas medidas a la práctica diaria de los servicios.Descriptores: Tuberculosis; Diagnóstico; Evaluación de los Servicios de Salud; Atención Primaria de la Salud.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Early diagnosis of tuberculosis in the health services in different regions of Brazil

Villa

Ponce

Wysocki³

et al. 2013

Rev. Latino-Am. Enfermagem

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“…Um trabalho realizado em Ribeirão Preto-SP (20) , entre junho de 2006 e julho de 2007, objetivou identificar e analisar a porta de entrada no sistema de saúde para o diagnóstico da TB. Para tanto, realizou-se entrevista estruturada com 100 doentes diagnosticados no período do estudo.…”

Section: Discussionunclassified

Diferenças nas características clínicas e epidemiológicas entre os casos notificados por tuberculose na atenção primária e terciária

Curbani¹,

Moreira²,

Guidon³

et al. 2013

Rev Bras Promoc Saude

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and epidemiological features between tuberculosis cases notified in primary and tertiary health care Diferencias de las caracteristicas clinicas y epidemiológicas de los casos notificados de tuberculosis en la atención primaria y terciaria RESUMO Objetivo: Comparar, quanto aos aspectos clínicos, radiológicos e epidemiológicos, todos os casos de tuberculose (TB) diagnosticados nos serviços terciários de atenção à saúde com aqueles diagnosticados no nível primário de atenção à saúde do município de Vitória-ES. Métodos: Estudo de corte transversal, retrospectivo, com análises do banco de dados do SINAN, para identificar todos os casos residentes no município de Vitória-ES e diagnosticados com tuberculose nos anos de 2006 e 2007. Os pacientes foram divididos em dois grupos: os diagnosticados na Atenção Primária à Saúde (APS) e os diagnosticados na Atenção Terciária à Saúde (ATS). Para análise estatística, utilizou-se o programa Stata Corp 9.0. Resultados: Identificou-se um total de 338 pacientes; destes, 207 (61,24%) diagnosticados na APS e 131 (38,76%) na ATS. Observou-se um predomínio da forma clínica pulmonar em ambos os grupos, todavia, a extrapulmonar apresentou maior frequência no grupo da ATS. Quando analisados os resultados da baciloscopia de escarro, a positividade foi encontrada em 114 (55,07%) dos pacientes da APS e em 57 (43,51%) da ATS. Com relação à positividade da cultura, 119 (57,48%) pacientes diagnosticados na APS e apenas 38 (29%) na ATS tiveram resultado positivo. Conclusão: Há evidência de elevada proporção de pacientes com TB notificados como "casos novos" na Atenção Terciária no município e foi notado um predomínio da forma clínica pulmonar em ambos os grupos -APS e ATS. Todavia, a extrapulmonar apresentou maior frequência neste. Descritores

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“…b Despite the availability of diagnostic materials and methods in Brazil, many areas have difficulties in timely detection of TB cases, either by not valuing coughing as a clinical symptom of the disease, not prioritizing sputum smear in diagnosis or by the lack of access to health care services and activities. 2,8,[14][15][16]18 This shows the need to qualify health care services, principally those that function as entry points to the health system in meeting sector reforms that prioritize opportune diagnosis of the disease as a control strategy.…”

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confidence: 99%

Diagnostico da tuberculose: atencao basica ou pronto atendimento?

Andrade¹,

Scatolin²,

Wysocki³

et al. 2013

Rev. Saude Publica

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OBJECTIVE:To assess primary health care and emergency medical services performance for tuberculosis diagnosis. METHODS:Cross-sectional study were conducted with 90 health professionals from primary health care and 68 from emergency medical services, in Ribeirao Preto, SP, Southeastern Brazil, in 2009. A structured questionnaire based on an instrument of tuberculosis care assessment was used. The association between health service and the variables of structure and process for tuberculosis diagnosis was assessed by Chi-square test, Fisher's exact test (both with 5% of statistical significance) and multiple correspondence analysis. RESULTS:Primary health care was associated with the adequate provision of inputs and human resources, as well as with the sputum test request. Emergencial medical services were associated with the availability of X-ray equipment, work overload, human resources turnover, insufficient availability of health professionals, unavailability of sputum collection pots and do not request sputum test. In both services, tuberculosis diagnosis remained as a physician's responsibility. CONCLUSIONS:Emergencial medical services presented weaknesses in its structure to identify tuberculosis suspects. Gaps on the process were identified in both primary health care and emergencial medical services. This situation highlights the need for qualification of health services that are the main gateway to health system to meet sector reforms that prioritize the timely diagnosis of tuberculosis and its control.

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A porta de entrada para o diagnóstico da tuberculose no sistema de saúde de Ribeirão Preto/SP

Cited by 34 publications

References 11 publications

Early diagnosis of tuberculosis in the health services in different regions of Brazil

Early diagnosis of tuberculosis in the health services in different regions of Brazil

Diferenças nas características clínicas e epidemiológicas entre os casos notificados por tuberculose na atenção primária e terciária

Diagnostico da tuberculose: atencao basica ou pronto atendimento?

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