Mudanças no manejo da tuberculose na atenção primária à saúde em decorrência da pandemia da Covid-19 no município de João Pessoa, Paraíba, Brasil

Abstract

Tuberculosis is characterized as a serious global health problem. It is estimated that 9.9 million people were affected by tuberculosis in 2020 worldwide. In the same year, a group of 16 countries, including Brazil, reduced 93% of tuberculosis notifications worldwide. Primary Health Care is the main entry point for people with tuberculosis. Today, during the Covid-19 pandemic, several countries had a negative impact on tuberculosis control actions due to reorganizations in services in search of mitigating the pandemic. In this sense, we objectively analyze the changes in the management of tuberculosis in Primary Health Care as a result of the Covid-19 pandemic in the municipality of João Pessoa, Paraíba, Brazil. This is an exploratory descriptive study that analyzes data with a qualitative approach and adopts the programmatic dimension of vulnerability as a theoretical framework. It was carried out in João Pessoa with a population made up of health professionals from Primary Health Services units. The sample size was defined using the saturation technique. As an inclusion criterion, being active in the service at least three months before March 2020 was considered. Units that did not treat cases of tuberculosis between 2020 and 2022 were excluded. Collection took place through a directive and open interview using a semi-structured script. The audios were transcribed into an Excel 2010 software spreadsheet and later organized and analyzed in Word 2016. The descriptive part of the professionals' characteristics was analyzed using descriptive statistics using absolute and relative frequency. For the analysis, the Content Analysis methodological framework was used. The project was approved by the Research Ethics Committee and meets the guidelines established in Resolution No. 466/12 of the National Health Council. Thirteen nurses working in the Basic Care Units of João Pessoa participated in the study, of which 84.6% were female, 46.1% were between 46 and 55 years old, 92.3% had worked in primary care for more than five years and 61.5% had worked in the current unit for more than five years. The categories that emerged from this study were: “Reality of health education regarding the prevention strategy and detection of TB: highlighted programmatic vulnerability”; “Scenario for monitoring patients with TB”; “The (in)visibility of APS-sensitive diseases during the pandemic”; “Access to health care and services”; “Structural and service adaptations”; and “Challenges facing human resources”. The statements highlighted the programmatic vulnerability in TB control during the pandemic, including the interruption of active search actions, cancellation of appointments, and access difficulties. To face future emergencies, it is crucial to invest in the continuing education of health professionals, strengthen Primary Care and reform health units to guarantee biosafety.