Aspectos epidemiológicos e de gestão do tratamento supervisionado no controle da tuberculose

Abstract

OBJECTIVE : Evaluate the effectiveness of supervised treatment in relation to epidemiological aspects and management of tuberculosis care in priority João Pessoa, Bayeux, Santa Rita, Campina Grande, Patos and Cajazeiras in the period 2001-2012. METHOD: Cross-sectional study of quantitative and qualitative approach that purports the study of old and new cases of a disease in a specific time and space. It was conducted from January to September/ 2013. It was made a secondary data collection in the Information System of Reportable Diseases-net and interviews with six coordinators of tuberculosis control actions. RESULTS: The municipalities under study from 2001 to 2012 presented 8.066 cases of tuberculosis, being 7.184 pulmonary cases and 882 of extra-pulmonary cases. João Pessoa showed the prevalence of 0,72%, Bayeux 0,58%, Santa Rita - 0,41%, Campina Grande - 0,50%, Patos - 0,60% and Cajazeiras - 0,66%. The outcomes were: Cure: João Pessoa 57,72%, Bayeux 74,15%, Santa Rita 76,44%, Campina Grande 63,00%, Patos 74,94% and Cajazeiras 79,26%; Abandonment: João Pessoa 13,18%, Bayeux 9,90%, Santa Rita 4,15%, Campina Grande 12,88%, Patos 6,63% and Cajazeiras 4,34%; The proportion of deaths: João Pessoa 10:100.000, Bayeux 3:100.000, Santa Rita 3:100.000, Campina Grande 1:100.000, Patos 3:100.000 and Cajazeiras 7:100.000. The qualitative data pointed that the coordinators of control actions has found as difficulties mainly, the resistance on the part of patients and professionals to develop the supervised treatment. Another found is that the use of drugs has hindered the therapy. CONCLUSION: Although the Directly Observed Treatment is a recommendation of the World Health Organization / Ministry of Health, consolidation continues to be identified as the main difficulty in efforts to control tuberculosis, and therefore, the characterization profile remained virtually unchanged, with high rates distant from the proposed targets. Efforts must be made to reverse the reality, even those no longer considered a priority. The difficulties pointed out by the managers should be targets of strategic actions; need an awareness / education on the importance of treatment of tuberculosis.