title: Tuberculosis diagnostic pathway in a municipality in south-eastern Brazil.
abstract: OBJECTIVE
  To analyse the pathway taken by tuberculosis (TB) patients from the first contact with the health services and the diagnosis of TB disease.
  
  
  METHODS
  In a survey conducted in a south-eastern municipality of Brazil prioritised for TB control, a structured questionnaire was applied to 100 TB patients under treatment; secondary data recorded in two information systems were also collected for analysis. Diagrams were constructed to represent the patient pathway through the health services up to diagnosis.
  
  
  RESULTS
  The emergency services were the point of entry into care for the majority of the patients. Those who first attended primary health care (PHC) centres needed to visit other health services for diagnosis.
  
  
  CONCLUSIONS
  Our study shows that multiple visits to multiple health services are required for the majority of patients to be diagnosed with TB. It is necessary to reinforce the referral path established for TB diagnosis and communication among providers, who should play a clear role in obtaining early diagnosis.
authors.affiliation: Ribeirão Preto School of Nursing, University of São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: M E F
authors.initials: MEF
authors.lastname: Brunello
authors.affiliation: Ribeirão Preto School of Nursing, University of São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: R L
authors.initials: RL
authors.lastname: de Paula Andrade
authors.affiliation: Ribeirão Preto School of Nursing, University of São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: A A
authors.initials: AA
authors.lastname: Monroe
authors.affiliation: Ribeirão Preto School of Nursing, University of São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: T
authors.initials: T
authors.lastname: Arakawa
authors.affiliation: Ribeirão Preto School of Nursing, University of São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: G T
authors.initials: GT
authors.lastname: Magnabosco
authors.affiliation: Ribeirão Preto School of Nursing, University of São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: N H
authors.initials: NH
authors.lastname: Orfão
authors.affiliation: Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil.
authors.forename: L M
authors.initials: LM
authors.lastname: Scatena
authors.affiliation: Ribeirão Preto School of Nursing, University of São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: T C S
authors.initials: TCS
authors.lastname: Villa
mesh_terms: D001938:Brazil; D003142:Communication; D003695:Delivery of Health Care / Q000379:methods / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D006801:Humans; D011320:Primary Health Care / Q000379:methods* / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000175:diagnosis*