Oferta de serviços pela atenção básica e detecção da incidência de tuberculose no Brasil

Detalhes bibliográficos
Autor(a) principal: Pelissari, Daniele Maria
Data de Publicação: 2018
Outros Autores: 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
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.
id USP-23_401aa5ab70b74eb0914776338484a438
oai_identifier_str oai:revistas.usp.br:article/145877
network_acronym_str USP-23
network_name_str Revista de Saúde Pública
repository_id_str
spelling 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