Oferta de serviços pela atenção básica e detecção da incidência de tuberculose no Brasil
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/145877 |
Resumo: | 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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Oferta de serviços pela atenção básica e detecção da incidência de tuberculose no BrasilOffer of primary care services and detection of tuberculosis incidence in BrazilTuberculosisepidemiology. Tuberculosisdiagnosis. Primary Health Care. Health Care QualityAccessand Evaluation.Tuberculoseepidemiologia. Tuberculosediagnóstico. Atenção Primária à Saúde. QualidadeAcesso e Avaliação da Assistência à Saúde.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.OBJETIVO: Avaliar a associação entre os serviços de saúde ofertados por equipes de atenção básica e a detecção de casos novos de tuberculose no Brasil. MÉTODOS: Estudo ecológico, abrangendo todos os municípios brasileiros que registraram pelo menos um caso novo de tuberculose (diagnosticado entre 2012 a 2014 e notificado no Sistema de Informação de Agravos de Notificação) e com pelo menos uma equipe de atenção básica avaliada pelo segundo ciclo do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB). As variáveis do PMAQ-AB foram classificadas como próximais ou distais, segundo a sua relação com o diagnóstico de tuberculose. Em seguida, foram testadas hierarquicamente em modelos múltiplos (ajustados por Unidade Federada), usando regressão binomial negativa. RESULTADOS: Um incremento de 10% na cobertura da atenção básica esteve associado à redução de 2,24% na taxa de detecção de tuberculose (IC95% -3,35– -1,11). No que se refere às variáveis proximais ao diagnóstico, no modelo múltiplo, a detecção da tuberculose esteve associada à proporção de equipes que: realizam vigilância de contatos (incremento na Razão de Taxas de Incidência [RTI] = 2,97%; IC95% 2,41–3,53); fazem busca ativa de casos de tuberculose (incremento na RTI = 2,17%; IC95% 1,48–2,87); e, ofertam cultura para micobactérias (incremento na RTI = 1,87%; IC95% 0,98–2,76). CONCLUSÕES: As variáveis relacionadas às ações de detecção estiveram positivamente associadas à detecção de casos novos de tuberculose, sugerindo uma contribuição significativa ao fortalecimento da sensibilidade do sistema de vigilância. Por outro lado, a cobertura da atenção básica esteve inversamente associada à taxa de detecção de tuberculose, o que poderia representar o efeito global da atenção básica sobre o controle da transmissão, provavelmente, através da identificação e tratamento precoce de casos.Universidade de São Paulo. Faculdade de Saúde Pública2018-05-03info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfapplication/xmlhttps://www.revistas.usp.br/rsp/article/view/14587710.11606/S1518-8787.2018052000131Revista de Saúde Pública; Vol. 52 (2018); 53Revista de Saúde Pública; Vol. 52 (2018); 53Revista de Saúde Pública; v. 52 (2018); 531518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporenghttps://www.revistas.usp.br/rsp/article/view/145877/139706https://www.revistas.usp.br/rsp/article/view/145877/139707https://www.revistas.usp.br/rsp/article/view/145877/148349Copyright (c) 2018 Revista de Saúde Públicainfo: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 Alexander2018-07-20T11:44:53Zoai:revistas.usp.br:article/145877Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2018-07-20T11:44:53Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Oferta de serviços pela atenção básica e detecção da incidência de tuberculose no Brasil Offer of primary care services and detection of tuberculosis incidence in Brazil |
title |
Oferta de serviços pela atenção básica e detecção da incidência de tuberculose no Brasil |
spellingShingle |
Oferta de serviços pela atenção básica e detecção da incidência de tuberculose no Brasil Pelissari, Daniele Maria Tuberculosis epidemiology. Tuberculosis diagnosis. Primary Health Care. Health Care Quality Access and Evaluation. Tuberculose epidemiologia. Tuberculose diagnóstico. Atenção Primária à Saúde. Qualidade Acesso e Avaliação da Assistência à Saúde. |
title_short |
Oferta de serviços pela atenção básica e detecção da incidência de tuberculose no Brasil |
title_full |
Oferta de serviços pela atenção básica e detecção da incidência de tuberculose no Brasil |
title_fullStr |
Oferta de serviços pela atenção básica e detecção da incidência de tuberculose no Brasil |
title_full_unstemmed |
Oferta de serviços pela atenção básica e detecção da incidência de tuberculose no Brasil |
title_sort |
Oferta de serviços pela atenção básica e detecção da incidência de tuberculose no Brasil |
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. Tuberculose epidemiologia. Tuberculose diagnóstico. Atenção Primária à Saúde. Qualidade Acesso e Avaliação da Assistência à Saúde. |
topic |
Tuberculosis epidemiology. Tuberculosis diagnosis. Primary Health Care. Health Care Quality Access and Evaluation. Tuberculose epidemiologia. Tuberculose diagnóstico. Atenção Primária à Saúde. Qualidade Acesso e Avaliação da Assistência à Saúde. |
description |
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 |
2018-05-03 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/145877 10.11606/S1518-8787.2018052000131 |
url |
https://www.revistas.usp.br/rsp/article/view/145877 |
identifier_str_mv |
10.11606/S1518-8787.2018052000131 |
dc.language.iso.fl_str_mv |
por eng |
language |
por eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/145877/139706 https://www.revistas.usp.br/rsp/article/view/145877/139707 https://www.revistas.usp.br/rsp/article/view/145877/148349 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2018 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2018 Revista de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf application/xml |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 52 (2018); 53 Revista de Saúde Pública; Vol. 52 (2018); 53 Revista de Saúde Pública; v. 52 (2018); 53 1518-8787 0034-8910 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_ |
1800221799789625344 |