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关于结核病控制的初级卫生服务机构基础设施:一项全国性横断面研究。

Facility infrastructure of primary health services regarding tuberculosis control: a countrywide cross-sectional study.

作者信息

Baumgarten Alexandre, Hilgert Juliana B, Pinto Ione C, Zacharias Fabiana C M, Bulgarelli Alexandre F

机构信息

Faculty of Dentistry, Epidemiology Postgraduate Program, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.

School of Nursing at Ribeirão Preto, Public Health Nursing Postgraduate Program at University of São Paulo, São Paulo, Brazil.

出版信息

Prim Health Care Res Dev. 2018 Sep 17;20:e67. doi: 10.1017/S1463423618000646.

Abstract

BACKGROUND

Tuberculosis (TB) is still a major public health problem in many countries, including Brazil. Primary health care (PHC) services are a set of important services with infrastructure and resources to diagnose, treat, and cure several diseases, including the TB.

AIM

The aim of this study is to analyse aspects of the facility infrastructure of Brazilian PHC, regarding the control and treatment of TB from a countrywide perspective.

METHODS

This is a cross-sectional study based on PHC services. Data were collected from 38,812 health centres and were assessed by means of the National Program for Improving Access and Quality Primary Care. The outcome was obtained by the presence and availability of the following infrastructure items: air circulation in the consultation room, refrigerator, individual protective equipment, plastic jar for sputum examination, and TB notification form of the primary care information system. Poisson regression was used to calculate the prevalence ratio.

FINDINGS

Of the 38,812 evaluated centres, only 1628 (4.2%) presented a positive result regarding the outcome. Primary health centres, among all types of centres, presented the highest quality of facility infrastructure for TB control. Centres with large workloads, as well as those that presented a list of offered services and a welcoming consulting room, also presented the highest quality infrastructure. The present study shows that major improvements should be made to the infrastructure to reach a satisfactory TB control in Brazil.

摘要

背景

结核病在包括巴西在内的许多国家仍然是一个主要的公共卫生问题。初级卫生保健(PHC)服务是一套重要的服务,具备诊断、治疗和治愈包括结核病在内的多种疾病的基础设施和资源。

目的

本研究旨在从全国范围的角度分析巴西初级卫生保健机构基础设施在结核病控制和治疗方面的情况。

方法

这是一项基于初级卫生保健服务的横断面研究。数据收集自38812个卫生中心,并通过国家改善初级卫生保健可及性和质量计划进行评估。结果通过以下基础设施项目的存在和可用性得出:诊疗室的空气流通、冰箱、个人防护设备、用于痰检的塑料罐以及初级保健信息系统的结核病报告表。采用泊松回归计算患病率比。

研究结果

在评估的38812个中心中,只有1628个(4.2%)在结果方面呈现阳性。在所有类型的中心中,初级卫生中心在结核病控制设施基础设施方面质量最高。工作量大的中心以及那些提供服务清单且诊疗室温馨的中心,其基础设施质量也最高。本研究表明,为在巴西实现令人满意的结核病控制,应大力改善基础设施。

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