Tuberculose: a calamidade negligenciada

Abstract

Epidemiological data on tuberculosis and the fight against the disease in Brazil and in the world are reviewed herein. Historical aspects of the different approaches to the control of the disease in Brazil are highlighted and the ongoing Brazilian Program for the Control of Tuberculosis is examined. To conclude, the author takes a look at unresolved problems and considers new alternatives for the control of tuberculosis.

A gerência da Unidade Básica de Saúde no controle da tuberculose: um campo de desafios

“…The TB decentralization results from a legal-juridical set that has been consolidated since the end of the 1980's, which makes the municipality the management of health actions (5)(6) . Nevertheless, the managerial decentralization finds obstacles in its operationalization, such as: the lack of technical ability and the low fiscal competence of the municipalities to take over such responsibilities, among others (1,7) . The manager presents the problem:…”

“…Therefore, the little participation in these discussions does not seem to have a relation with the work period in this position. When TB is recognized as a neglected disease (1) , we come across a complex context in which PHC professionals have difficulties to diagnose TB and the health services lack the appropriate managerial organization to provide care to the patients (5) .…”

“…In 1993, the World Health Organization (WHO) declared TB as a state of urgency and created the STOP TB program, which is formed by institutions of high scientific level and/or economic power, such as the WHO, the World Bank, Centers for Disease Control (CDC)-Atlanta, International Union Against Tuberculosis and Lung Disease (IUATLD), Royal Netherlands Tuberculosis Association (RNTA) and American Thoracic Association (ATA) (1) .…”

Cobertura do tratamento diretamente observado (DOTS) da Tuberculose no Estado de São Paulo (1998 a 2004)

“…A Tuberculose (TB) é uma endemia que esteve presente como problema de saúde pública no Brasil durante todo o século XX (1) , e ficou conhecida como a calamidade negligenciada (2) . Ela esteve controlada até meados da década de 80, sendo então esquecida pelas políticas públi-cas de saúde, ressurgindo no final desta década com grande número de casos.…”

Preliminary validation of an instrument to assess social support and tuberculosis stigma in patients' families

“…1,2 In Brazil, the TB health challenge is strongly influenced by social determinants and shows a direct relationship with poverty and social exclusion, of which stigma is an important component. 3,4 The term stigma was originally described by Goffman to refer to a devalued or undesirable social attribute. 5 This attribute may be a physical or social issue that provokes negative feelings and consequently causes the individual to become marginalised or excluded from social relationships.…”