Offer of primary care services and detection of tuberculosis incidence in Brazil
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102018000100244 |
Resumo: | ABSTRACT OBJECTIVE To evaluate the association between the health services offered by primary care teams and the detection of new tuberculosis cases in Brazil. METHODS This was an ecological study covering all Brazilian municipalities that registered at least one new tuberculosis case (diagnosed between 2012 to 2014 and notified in the Information System of Notifiable Diseases) and with at least one primary care team evaluated by the second cycle of the National Program for Improving Access and Quality of Primary Care (PMAQ-AB). The variables of the PMAQ-AB were classified as proximal or distal, according to their relation with the tuberculosis diagnosis. Then, they were tested hierarchically in multiple models (adjusted by States) using negative binomial regression. RESULTS An increase of 10% in the primary health care coverage was associated with a decrease of 2.24% in the tuberculosis detection rate (95%CI -3.35– -1.11). Regarding the proximal variables in relation to diagnosis, in the multiple model, the detection of tuberculosis was associated with the proportion of teams that conduct contact investigation (increase in Incidence Rate Ratio [IRR] = 2.97%, 95%CI 2.41–3.53), carry out tuberculosis active case finding (increase in IRR = 2.17%, 95%CI 1.48–2.87), and request culture for mycobacteria (increase in IRR = 1.87%, 95%CI 0.98–2.76). CONCLUSIONS The variables related to the search actions were positively associated with the detection of new tuberculosis cases, which suggests a significant contribution to the strengthening of the sensitivity of the surveillance system. On the other hand, primary care coverage was inversely associated with the tuberculosis detection rate, which could represent the overall effect of the primary care on transmission control, probably from the identification and early treatment of cases. |
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Offer of primary care services and detection of tuberculosis incidence in BrazilTuberculosis, epidemiologyTuberculosis, diagnosisPrimary Health CareHealth Care Quality, Access, and EvaluationABSTRACT OBJECTIVE To evaluate the association between the health services offered by primary care teams and the detection of new tuberculosis cases in Brazil. METHODS This was an ecological study covering all Brazilian municipalities that registered at least one new tuberculosis case (diagnosed between 2012 to 2014 and notified in the Information System of Notifiable Diseases) and with at least one primary care team evaluated by the second cycle of the National Program for Improving Access and Quality of Primary Care (PMAQ-AB). The variables of the PMAQ-AB were classified as proximal or distal, according to their relation with the tuberculosis diagnosis. Then, they were tested hierarchically in multiple models (adjusted by States) using negative binomial regression. RESULTS An increase of 10% in the primary health care coverage was associated with a decrease of 2.24% in the tuberculosis detection rate (95%CI -3.35– -1.11). Regarding the proximal variables in relation to diagnosis, in the multiple model, the detection of tuberculosis was associated with the proportion of teams that conduct contact investigation (increase in Incidence Rate Ratio [IRR] = 2.97%, 95%CI 2.41–3.53), carry out tuberculosis active case finding (increase in IRR = 2.17%, 95%CI 1.48–2.87), and request culture for mycobacteria (increase in IRR = 1.87%, 95%CI 0.98–2.76). CONCLUSIONS The variables related to the search actions were positively associated with the detection of new tuberculosis cases, which suggests a significant contribution to the strengthening of the sensitivity of the surveillance system. On the other hand, primary care coverage was inversely associated with the tuberculosis detection rate, which could represent the overall effect of the primary care on transmission control, probably from the identification and early treatment of cases.Faculdade de Saúde Pública da Universidade de São Paulo2018-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102018000100244Revista de Saúde Pública v.52 2018reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USP10.11606/s1518-8787.2018052000131info:eu-repo/semantics/openAccessPelissari,Daniele MariaBartholomay,PatriciaJacobs,Marina GasinoArakaki-Sanchez,DeniseAnjos,Davllyn Santos Oliveira dosCosta,Mara Lucia dos SantosCavalcanti,Pauline Cristine da SilvaDiaz-Quijano,Fredi Alexandereng2018-05-18T00:00:00Zoai:scielo:S0034-89102018000100244Revistahttp://www.scielo.br/scielo.php?script=sci_serial&pid=0034-8910&lng=pt&nrm=isoONGhttps://old.scielo.br/oai/scielo-oai.phprevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2018-05-18T00:00Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Offer of primary care services and detection of tuberculosis incidence in Brazil |
title |
Offer of primary care services and detection of tuberculosis incidence in Brazil |
spellingShingle |
Offer of primary care services and detection of tuberculosis incidence in Brazil Pelissari,Daniele Maria Tuberculosis, epidemiology Tuberculosis, diagnosis Primary Health Care Health Care Quality, Access, and Evaluation |
title_short |
Offer of primary care services and detection of tuberculosis incidence in Brazil |
title_full |
Offer of primary care services and detection of tuberculosis incidence in Brazil |
title_fullStr |
Offer of primary care services and detection of tuberculosis incidence in Brazil |
title_full_unstemmed |
Offer of primary care services and detection of tuberculosis incidence in Brazil |
title_sort |
Offer of primary care services and detection of tuberculosis incidence in Brazil |
author |
Pelissari,Daniele Maria |
author_facet |
Pelissari,Daniele Maria Bartholomay,Patricia Jacobs,Marina Gasino Arakaki-Sanchez,Denise Anjos,Davllyn Santos Oliveira dos Costa,Mara Lucia dos Santos Cavalcanti,Pauline Cristine da Silva Diaz-Quijano,Fredi Alexander |
author_role |
author |
author2 |
Bartholomay,Patricia Jacobs,Marina Gasino Arakaki-Sanchez,Denise Anjos,Davllyn Santos Oliveira dos Costa,Mara Lucia dos Santos Cavalcanti,Pauline Cristine da Silva Diaz-Quijano,Fredi Alexander |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Pelissari,Daniele Maria Bartholomay,Patricia Jacobs,Marina Gasino Arakaki-Sanchez,Denise Anjos,Davllyn Santos Oliveira dos Costa,Mara Lucia dos Santos Cavalcanti,Pauline Cristine da Silva Diaz-Quijano,Fredi Alexander |
dc.subject.por.fl_str_mv |
Tuberculosis, epidemiology Tuberculosis, diagnosis Primary Health Care Health Care Quality, Access, and Evaluation |
topic |
Tuberculosis, epidemiology Tuberculosis, diagnosis Primary Health Care Health Care Quality, Access, and Evaluation |
description |
ABSTRACT OBJECTIVE To evaluate the association between the health services offered by primary care teams and the detection of new tuberculosis cases in Brazil. METHODS This was an ecological study covering all Brazilian municipalities that registered at least one new tuberculosis case (diagnosed between 2012 to 2014 and notified in the Information System of Notifiable Diseases) and with at least one primary care team evaluated by the second cycle of the National Program for Improving Access and Quality of Primary Care (PMAQ-AB). The variables of the PMAQ-AB were classified as proximal or distal, according to their relation with the tuberculosis diagnosis. Then, they were tested hierarchically in multiple models (adjusted by States) using negative binomial regression. RESULTS An increase of 10% in the primary health care coverage was associated with a decrease of 2.24% in the tuberculosis detection rate (95%CI -3.35– -1.11). Regarding the proximal variables in relation to diagnosis, in the multiple model, the detection of tuberculosis was associated with the proportion of teams that conduct contact investigation (increase in Incidence Rate Ratio [IRR] = 2.97%, 95%CI 2.41–3.53), carry out tuberculosis active case finding (increase in IRR = 2.17%, 95%CI 1.48–2.87), and request culture for mycobacteria (increase in IRR = 1.87%, 95%CI 0.98–2.76). CONCLUSIONS The variables related to the search actions were positively associated with the detection of new tuberculosis cases, which suggests a significant contribution to the strengthening of the sensitivity of the surveillance system. On the other hand, primary care coverage was inversely associated with the tuberculosis detection rate, which could represent the overall effect of the primary care on transmission control, probably from the identification and early treatment of cases. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102018000100244 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102018000100244 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.11606/s1518-8787.2018052000131 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Faculdade de Saúde Pública da Universidade de São Paulo |
publisher.none.fl_str_mv |
Faculdade de Saúde Pública da Universidade de São Paulo |
dc.source.none.fl_str_mv |
Revista de Saúde Pública v.52 2018 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1748936504714985472 |