OBJECTIVE:To assess diffi culties in the accessibility to tuberculosis diagnoses in the health services in Brazil.

Objective: To analyze the infected person's first contact with the health services, for the early diagnosis of tuberculosis (TB) in different regions of Brazil. Method: a cross-sectional study undertaken in 6 municipalities in the South-east, South and North-east regions of Brazil. Data collection involved secondary sources and interviews with the patients. The data was analyzed using descriptive techniques and multiple correspondence factor analysis. Results: Primary Health Care (PHC) presented the longest time to diagnosis and the lowest proportion of diagnoses. The services associated with diagnosis in the first consultation were the specialized services and the Tuberculosis Control Programs, which offer consultations and tests on-site. Conclusion: For the control of TB, it is necessary to organize the work in an integrated way between the different services' teams. In Primary Health Care, it is also necessary to observe the extent of incorporation and sustainability in the implementation of these actions into the health services' daily practice. a Atenção Primária à Saúde apresentou maior tempo e menor proporção de diagnósticos. Os serviços associados ao diagnóstico, na primeira consulta, foram os serviços especializados e os Programas de Controle da TB, que oferecem consulta e exames no próprio local. Conclusão:faz-se necessária a organização do trabalho de forma integrada, entre as equipes dos diferentes serviços, para as ações de controle da TB. Na Atenção Primária à Saúde, é preciso ainda observar o grau de incorporação e sustentabilidade na execução dessas ações à prática diária dos serviços.Descritores: Tuberculose; Diagnóstico; Avaliação de Serviços de Saúde; Atenção Primária à Saúde. El diagnóstico oportuno de la tuberculosis en los servicios de salud de varias regiones de BrasilObjetivo: Analizar el primer contacto del paciente con los servicios de salud para el diagnóstico oportuno de la tuberculosis (TB) en diferentes regiones de Brasil. Método: Estudio transversal en seis ciudades en el sudeste, sur y noreste. La recolección de datos utilizó fuentes secundarias y entrevistas con los pacientes. Los datos fueron analizados utilizando técnicas descriptivas y el análisis factorial de correspondencias múltiples. Resultados: La Atención Primaria obtuve menor proporción de diagnósticos y mayor tiempo. Los servicios asociados con el diagnóstico en la primera visita fueron los servicios especializados y los Programas de Control de la Tuberculosis, que ofrecen consultas y exámenes in situ. Conclusión: Es necesaria la organización del trabajo integrado entre los equipos de los diferentes servicios para las acciones de control. En la Atención Primaria, es necesario también observar el grado de desarrollo y sostenibilidad en la aplicación de estas medidas a la práctica diaria de los servicios.Descriptores: Tuberculosis; Diagnóstico; Evaluación de los Servicios de Salud; Atención Primaria de la Salud.

The factor analysis enabled the visualization of the organizational characteristics of the services that provide tuberculosis care. The decentralization of the actions to the family health program and reference centers seems not to present a satisfactory performance regarding accessibility to the tuberculosis diagnosis, as the form of services organization was not a determinant factor to guarantee the accessibility to the early diagnosis of the illness.

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