Picanço Larissa, Dutra Rinelly Pazinato, Saes Mirelle de Oliveira
Universidade Federal do Rio Grande, Rio Grande, Brasil.
Hospital Escola, Universidade Federal de Pelotas, Pelotas, Brasil.
Cad Saude Publica. 2024 Mar 11;40(3):e00087723. doi: 10.1590/0102-311XPT087723. eCollection 2024.
This study aimed to analyze the presence of infrastructure and adequate work processes in primary health care (PHC) for the diagnosis, monitoring, and treatment of tuberculosis (TB) in Brazil from 2012 to 2018. This is a temporal trend study carried out with data from basic health units (BHU) evaluated in the cycles I (2012), II (2014), and III (2018) of the Brazilian National Program for Improvement of Access and Quality of Basic Care (PMAQ-AB). Variance-weighted least-squares regression was used to estimate annual changes, in percentage points, of the infrastructure and adequate work process of TB in relation to the macroregion, municipality size, Municipal Human Development Index, and Family Health Strategy coverage. The sample consisted of 13,842 BHU and 17,202 health teams in cycle I; 24,055 BHU and 29,778 teams in cycle II; and 28,939 BHU and 37,350 teams in cycle III. There was a gradual improvement in the proportion of infrastructure and work process for TB care over the three cycles of the PMAQ-AB, but none of the sites is fully adequate. The greatest trend of adequate infrastructure was observed in the South Region, and in 2018, 76.5% of the UBS had all the instruments for TB care. The greatest trend of adequate work process was in the North Region, and in 2018, 50.8% of the teams had all the items for TB care. The Brazilian National Program for Tuberculosis Control and the PMAQ-AB have contributed to these advances, but there is still a need to promote public policies that ensure the continuous improvement of TB care in PHC, the effectiveness of TB control and prevention measures.
本研究旨在分析2012年至2018年巴西初级卫生保健（PHC）中用于结核病（TB）诊断、监测和治疗的基础设施及适当工作流程的情况。这是一项时间趋势研究，采用了巴西国家基本医疗服务可及性与质量提升计划（PMAQ-AB）第一周期（2012年）、第二周期（2014年）和第三周期（2018年）中对基本卫生单位（BHU）评估的数据。采用方差加权最小二乘法回归来估计结核病基础设施和适当工作流程相对于大区、城市规模、城市人类发展指数以及家庭健康战略覆盖范围的年度变化（以百分点计）。样本在第一周期包括13,842个基本卫生单位和17,202个卫生团队；第二周期包括24,055个基本卫生单位和29,778个团队；第三周期包括28,939个基本卫生单位和37,350个团队。在PMAQ-AB的三个周期中，结核病护理的基础设施和工作流程比例有逐步改善，但没有一个地点是完全充足的。在南部地区观察到充足基础设施的最大改善趋势，2018年，76.5%的基本卫生单位拥有所有结核病护理仪器。充足工作流程的最大改善趋势在北部地区，2018年，50.8%的团队拥有所有结核病护理项目。巴西国家结核病控制计划和PMAQ-AB促成了这些进展，但仍需推行公共政策，以确保初级卫生保健中结核病护理的持续改善、结核病控制和预防措施的有效性。
