Acompanhamento dos casos novos de tuberculose: perfil clínico-pidemiológico e organização do serviço de saúde

Abstract

Objective: To describe the epidemiology and clinical data of tuberculosis patients, as well as monitoring by health services, and the relationship with the cure of new cases. Methods: Epidemiological and analytical study of new cases of tuberculosis diagnosed and residents in Manaus during 2014, according to the healing situation. Interviews with closed questions allowed the characterization of the subjects in terms of socioeconomic, demographic, health- disease process, relationship with health services and treatment outcome were applied to the subjects in the 1st and 6th month of treatment. The analyses were performed in the following sequence: (i) exploratory analysis and (ii) bivariate analysis with chi-square test at significance level under 5%. Results: We recruited 139 subjects, of whom 113 were cured, 2 deaths, 15 default treatment and 9 were still on treatment at 6th month. Most individuals are male, young adults, predominantly brown color and with low education. Among the patients pulmonary with sputum smear positive (72 cases), healing was associated to non-smokers, no use of illegal drugs, conducting control sputum smear, scheduling visits by doctors or nurses, care by the same professionals, sharing doubts about the disease and treatment with health professionals, not receiving home visit and the desire to continue treatment in the unit for which he was forwarded. Among the pulmonary cases of sputum smear negative (37 cases), the cure was associated to non-smokers, and among the extrapulmonary cases (19 cases) the cure was associated to appointments in the unit through records and care always by the same professionals. Conclusion: There are aspects that indicate weaknesses in the health services, among which, the concentration of TB diagnosis at the referral center of the city, even after the decentralization of the control actions to the basic municipal health network. Thus, there is the need to rethink a healthcare model that incorporates indeed the primary care as a gateway for the diagnosis, and in that context performing early diagnosis, treatment in an appropriate and timely manner, with appropriate follow-up of cases