de Sá Lenilde Duarte, de Andrade Marclineide Nóbrega, Nogueira Jordana de Almeida, Villa Tereza Cristina Scatena, de Figueiredo Tânia Maria Ribeiro Monteiro, de Queiroga Rodrigo Pinheiro Fernandes, de Sousa Maria Clemilde Mouta
Universidade Federal da Paraíba, João Pessoa, PB, 58045-550, Brazil.
Cien Saude Colet. 2011 Sep;16(9):3917-24. doi: 10.1590/s1413-81232011001000028.
The scope of this paper is to analyze the implementation of the Directly Observed Treatment Short-Course (DOTS) strategy in the control of tuberculosis, from the standpoint of the coordinators of the Tuberculosis Control Program (TCP) in six priority municipalities in the state of Paraíba, Brazil. Semi-structured interviews were conducted with seven TCP coordinators. Five municipalities proved to be DOTS success points achieving a 90% cure rate. Among the DOTS weak points in the political dimension, the following aspects were identified: lack of continuity of the TCP coordinator position; lack of preparedness of the local team; precarious technical-administration structure and insufficiency of the laboratory network. In the operational dimension, the search for respiratory symptoms by the Family Health Teams is still low. Changes of an epidemiological, operational and political nature have been incorporated, though the implementation and guarantee of the sustainability of DOTS in the State depends on the way the health services are organized and on the manager's political commitment to support the strategy.
本文的范围是从巴西帕拉伊巴州六个重点市结核病控制项目(TCP)协调员的角度,分析直接观察短程治疗(DOTS)策略在结核病控制中的实施情况。对七位TCP协调员进行了半结构化访谈。五个市被证明是DOTS成功点,治愈率达到90%。在DOTS政治层面的薄弱点中,确定了以下几个方面:TCP协调员职位缺乏连续性;当地团队准备不足;技术管理结构不稳定以及实验室网络不足。在操作层面,家庭健康团队对呼吸道症状的筛查率仍然很低。尽管DOTS在该州的实施和可持续性保障取决于卫生服务的组织方式以及管理者对该策略的政治支持力度,但已经纳入了流行病学、操作和政治性质的变革。