title: [Tuberculosis diagnosis: primary health care or emergency medical services?].
abstract: OBJECTIVE
  To assess primary health care and emergency medical services performance for tuberculosis diagnosis.
  
  
  METHODS
  Cross-sectional study were conducted with 90 health professionals from primary health care and 68 from emergency medical services, in Ribeirao Preto, SP, Southeastern Brazil, in 2009. A structured questionnaire based on an instrument of tuberculosis care assessment was used. The association between health service and the variables of structure and process for tuberculosis diagnosis was assessed by Chi-square test, Fisher's exact test (both with 5% of statistical significance) and multiple correspondence analysis.
  
  
  RESULTS
  Primary health care was associated with the adequate provision of inputs and human resources, as well as with the sputum test request. Emergencial medical services were associated with the availability of X-ray equipment, work overload, human resources turnover, insufficient availability of health professionals, unavailability of sputum collection pots and do not request sputum test. In both services, tuberculosis diagnosis remained as a physician's responsibility.
  
  
  CONCLUSIONS
  Emergencial medical services presented weaknesses in its structure to identify tuberculosis suspects. Gaps on the process were identified in both primary health care and emergencial medical services. This situation highlights the need for qualification of health services that are the main gateway to health system to meet sector reforms that prioritize the timely diagnosis of tuberculosis and its control.
authors.forename: Rubia Laine de Paula
authors.initials: RL
authors.lastname: Andrade
authors.forename: Beatriz Estuque
authors.initials: BE
authors.lastname: Scatolin
authors.forename: Anneliese Domingues
authors.initials: AD
authors.lastname: Wysocki
authors.forename: Aline Ale
authors.initials: AA
authors.lastname: Beraldo
authors.forename: Aline Aparecida
authors.initials: AA
authors.lastname: Monroe
authors.forename: Lúcia Marina
authors.initials: LM
authors.lastname: Scatena
authors.forename: Tereza Cristina Scatena
authors.initials: TC
authors.lastname: Villa
authors.forename: Maria Amélia Zanon
authors.initials: MA
authors.lastname: Ponce
authors.forename: Tiemi
authors.initials: T
authors.lastname: Arakawa
mesh_terms: D001938:Brazil; D003430:Cross-Sectional Studies; D003954:Diagnostic Services; D004632:Emergency Medical Services; D005163:Factor Analysis, Statistical; D006296:Health Services; D006297:Health Services Accessibility; D006801:Humans; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000175:diagnosis*