Atraso na busca por serviço de saúde para o diagnóstico da tuberculose em Ribeirão Preto (SP)

Abstract

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.

Estratégias Para Capacitação Ao Cuidado Em Tuberculose

“…No entanto, as equipes de saúde devem incluir ações educativas que não se restrinjam apenas a panfletos e palestras, e sim em um diálogo que promova a aproximação equipe/usuário (22) . É de fundamental importância o conhecimento sobre a TB, o acesso às informações através dos meios de comunicação, das escolas e de intervenções educativas com o intuito de reduzir o estigma e o impacto das consequências sociais da TB, como também a idealização de programas de educação continuada em saúde, projetados para aumentar o nível de conhecimento em toda a população e como forma de melhorar o acesso dos doentes aos serviços de saúde para o diagnóstico precoce da doença (23) .…”

Illness Experience in a Very Low Income/Poor District of Rio de Janeiro, Brazil: Tuberculosis, Medication Adherence and Common Mental Disorders

“…It is important the professional welcoming posture and greater understanding of their numerous difficulties for the treatment [25] [26]. From the professional point of view, there is an accumulation of functions, lack of preparation when dealing with the patient in addition to precariousness of working links.…”

“…A study on therapeutic itinerary in Ribeirão Preto, São Paulo, showed that 69%, 16% and 15% of users preferred emergency services, PHC unit and other services, respectively, as stated in this research. Several explanations can be given, but a major factor is the resolute capacity of the ER units with greater access to tests and their operating regime (24 hours) [25].…”

Diagnostico da tuberculose: atencao basica ou pronto atendimento?

“…12 ES was the preferred gateway for public health care service users in Ribeirao Preto. 2,16 Studies 9,10,16,20,d show that PHC and ES are most sought at the onset of TB symptoms. The aim, therefore, was to contribute to the production of knowledge aimed at evaluating health care services and formulating public policies leading to timely diagnosis of the disease in the health care system network.…”

“…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.…”