Performance of primary healthcare services in tuberculosis control.
OBJECTIVE
To assess the access to tuberculosis treatment in healthcare services with Programa Saúde da Família (PSF - Family Health Program) and at a reference outpatient clinic.


METHODS
A descriptive inquiry was carried out in 2007 with 106 patients who received tuberculosis treatment through the PSF or the reference outpatient clinic in Campina Grande, Northeastern Brazil, from July 2006 to August 2007. To assess the health services, the instrument Primary Care Assessment Tool was used, validated and adapted to assess tuberculosis care in Brazil. The main variables analyzed referred to the transportation and distance to the service and patients' supervision.


RESULTS
Of the 106 patients, 83.9% performed self-administered treatment and 16.0% received supervised treatment. The indicators from the PSF units and from the reference outpatient clinic that were similar (p>0.05) were: 65.1% 'losing half work day to attend the medical visit'; 65.0% 'having to use motorized transport'; 50.0% 'always having to pay for motorized transport'; and 69.0% 'not receiving treatment at healthcare units near home'. The indicators 'using motorized transport', 'paying for transport to attend the medical visit' and 'receiving treatment near home' were statistically different (p<0.05) between the services. Standardized and non-standardized Cronbach's alpha coefficients were, respectively, 0.7275 and 0.7075, based on the eight items of the questionnaire.


CONCLUSIONS
Although the city has 85 PSF teams, supervised treatment was carried out by few health workers. Although the tuberculosis treatment is offered by the public health service, it still represents a cost to the patients, due to the distance to the healthcare service and losing half work day in order to attend medical visits.
Figueiredo
Tânia Maria Ribeiro Monteiro de
TM
Departamento de Enfermagem, Núcleo de Estudos e Pesquisas Epidemiológicas, Universidade Estadual da Paraíba, Campina Grande, PB, Brasil. taniaribeiro_2@hotmail.com
Villa
Tereza Cristina Scatena
TC
Scatena
Lúcia Marina
LM
Cardozo Gonzales
Roxana Isabel
RI
Ruffino-Netto
Antonio
A
Nogueira
Jordana de Almeida
Jde A
Oliveira
Arleusson Ricarte de
AR
Almeida
Sandra Aparecida de
SA
D000293:Adolescent; D000995:Antitubercular Agents / Q000008:administration & dosage; D001938:Brazil; D023801:Directly Observed Therapy / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005192:Family Health; D005260:Female; D006078:Government Programs; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009313:National Health Programs; D020380:Needs Assessment; D010045:Outpatients / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D014376:Tuberculosis / Q000188:drug therapy / Q000517:prevention & control*
D000995:Antitubercular Agents