[Obstacles to overcome in the control of pulmonary tuberculosis in the border region of Chiapas, Mexico].

OBJECTIVE

To improve the control of the pulmonary tuberculosis in the Border Region of Chiapas, Mexico.

DESIGN

Academic researchers, health development workers from the nongovernmental sector and government health authorities met in a workshop to analyze recent experiences with tuberculosis.

RESULTS

Among the important issues addressed were: with regard to official health services, the lack of resources, particularly medication, organizational problems which result in poor or absent communication within and among different health entities, the under diagnosis of cases and the lack of sufficient index of suspicion for tuberculosis among health personnel. With regard to the population at risk, there are profound socio-cultural barriers which include a lack of confidence in the quality of government health care centers and little attention given to chronic cough. Poorest, indigenous and more remote people have less access to care and are more likely to have advanced tuberculosis before seeking treatment if at all. New strategies proposed were to integrate communication efforts in tuberculosis control among all the involved health services, including private physicians, identify those patients at greatest risk, improve diagnostic skills of health providers, develop education campaigns in rural areas.

CONCLUSIONS

Certain factors which impede better TB control seem amenable to change, others, such as severe poverty, particularly among peasants and indigeneous people, as well as the current political disruption, will require much broader intersectorial interventions.