Analysis of the Tuberculosis Control Program in the city of Cáceres, Brazil, prior to and after the implementation of a Family Health Program.
OBJECTIVE
To analyze the effectiveness of the Tuberculosis Control Program, in conjunction with the recently incorporated Family Health Program, in the city of Cáceres, Brazil, between 1999 and 2004.


METHODS
This was a descriptive epidemiological study, based on the registry of tuberculosis cases diagnosed and treated in Cáceres, according to the characteristics of the cases diagnosed, whether or not the protocol for diagnosis, treatment, and monitoring of patients was followed, as well as the type of health care facility involved.


RESULTS
The incidence of tuberculosis was reduced from 99.4 to 49.8 (per 100,000 inhabitants) between 1999 and 2004. The patients presented characteristics similar to those of patients from other regions of Brazil, with a predominance of males during their most economically productive years. Among the patients presenting pulmonary forms and treated via the Family Health Program, there was a reduction in the number of sputum smear microscopies performed at the moment of diagnosis (OR = 0.33; 95%CI: 0.16-0.66) and prior to discharge (OR = 0.32; 95%CI: 0.180.59). The patients monitored via the Family Health Program presented a 16.4% lower cure rate than did those treated at the referral center, as well as being more likely to abandon treatment (OR = 2.93; 95%CI: 1.15-7.46) and to die (OR = 5.71; 95%CI: 1.8518.1).


CONCLUSIONS
The decentralization of the treatment services to the family health clinics did not improve the treatment or monitoring of tuberculosis cases in the city of Cáceres.
Ignotti
Eliane
E
Universidade Estadual de Mato Grosso, Cáceres, MT, Brasil. eignotti@uol.com.br
Oliveira
Beatriz Fátima Alves de
BF
Hartwig
Shaiana
S
Oliveira
Hellen Caroline de
HC
Scatena
João Henrique Gurtler
JH
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D023801:Directly Observed Therapy / Q000379:methods; D004812:Epidemiologic Methods; D005192:Family Health; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D010352:Patient Dropouts / Q000706:statistics & numerical data; D015397:Program Evaluation; D017678:Sex Distribution; D013997:Time Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology