title: [Tuberculosis diagnosis and performance assessment of the first health service used by patients in São José do Rio Preto, São Paulo State, Brazil].
abstract: This cross-sectional study aimed to analyze the first health service to which patients turned for tuberculosis diagnosis in São José do Rio Preto, São Paulo, Brazil, 2009. Eighty-one patients in treatment were interviewed with a questionnaire based on the Primary Care Assessment Tool adapted to TB care and used as a reference for health services performance (structure and process). Data analysis used descriptive and multiple correspondence techniques. Nearly half of the patients initially came to emergency care departments (49.4%), and most TB diagnoses were made in hospitals (39.5%) and primary care services (30.9%). Specialized services were associated with the best diagnostic performance, as opposed to emergency departments, with the worst performance. Primary care services were associated with intermediate performance and weaknesses in infrastructure. The reach of effective detection of TB cases in the portals of entry into the health system involves enhanced diagnostic suspicion, thus emphasizing the need for investments in the management of human resources training for the identification of individuals with respiratory symptoms.
authors.affiliation: Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil. amelinha_famerp@yahoo.com.br
authors.forename: Maria Amélia Zanon
authors.initials: MA
authors.lastname: Ponce
authors.forename: Anneliese Domingues
authors.initials: AD
authors.lastname: Wysocki
authors.forename: Beatriz Estuque
authors.initials: BE
authors.lastname: Scatolin
authors.forename: Rubia Laine de Paula
authors.initials: RL
authors.lastname: Andrade
authors.forename: Tiemi
authors.initials: T
authors.lastname: Arakawa
authors.forename: Antonio
authors.initials: A
authors.lastname: Ruffino Netto
authors.forename: Aline Aparecida
authors.initials: AA
authors.lastname: Monroe
authors.forename: Lucia Marina
authors.initials: LM
authors.lastname: Scatena
authors.forename: Sílvia Helena Figueiredo
authors.initials: SH
authors.lastname: Vendramini
authors.forename: Tereza Cristina Scatena
authors.initials: TC
authors.lastname: Villa
mesh_terms: D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006801:Humans; D015994:Incidence; D011320:Primary Health Care; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology