A influência da Estratégia de Saúde da Família na Efetividade do Controle da Tuberculose no Brasil.

Abstract

Despite the progress made in controlling tuberculosis in recent decades, in terms of reducing its occurrence and mortality, we had no significant improvements in the rate of treating or abandoning the disease, including not achieving the goals recommended by international organizations so that tuberculosis ceases to be a great problem to the Brazilian public health. It is believed that the decentralization of tuberculosis control actions for primary care through the ESF would contribute to its control. Thus, the objective of this study was to analyze the influence of the ESF in the effectiveness of tuberculosis control in Brazilian cities from 2009 to 2011. The population that was analyzed for this study was composed of new cases of pulmonary tuberculosis, diagnosed and reported from 2009 to 2011.This study evaluated, through a historical cohort, the relationship between the treatment of tuberculosis and individual factors related to health services and structural collectives; and through a hierarchical logistic regression, odds ratios were calculated and adjusted for these factors. In this research we used data from secondary banks. We had observed the relationship between the treatment of tuberculosis and the supervised treatment received by the patient. It was also observed if the patient was treated at a health facility with ESF and if the patient performed tuberculosis control activities and if the patient already had diabetes. The model proposed in this study showed that regardless of individual and environmental factors, in addition to other service factors such as the completion of the TDO, the ESF contributes to the control of tuberculosis and increases the chances of treatment. However, in addition to the implementation of the ESF, we evaluated whether these tuberculosis control actions were in accordance with the guidelines of the Ministry of Health, based on the evaluation of primary care quality. Our findings indicate that the chance of treatment is even higher among the cases treated in units with ESF, developing TB control activities of the best quality. This study concluded that the actions of the ESF can contribute to improving the cure rate of tuberculosis and influencing its control in Brazil.