Tuberculosis is a worldwide public health problem, which, even with available
treatment, continues to cause deaths worldwide. One of the obstacles to control
the disease is the multifactorial difficulty of patients to adhere to treatment,
in addition to the difficulty of health workers in circumventing barriers to
implement strategies such as the directly observed treatment (DOT). The aim of
this study is to analyze the performance and challenges faced by health workers
in the use of DOT in tuberculosis. This is a descriptive, quali-quantitative
study using data from interviews with primary-care professionals working in nine
municipalities of Parana State, Brazil. The professionals answered a
questionnaire containing four closed questions about DOT and an open question
related to their professional opinion about the strategy. Quantitative data were
entered into a spreadsheet and statistically propagated. Qualitative data were
treated from the transcription of statements, subsequently submitted to content
analysis. Of the 387 professionals interviewed, at least 58.9% had some
knowledge about DOT. Among the main challenges faced by the professionals are:
lack of user commitment to treatment (48.3%), users' difficulty in attending the
basic health clinics (BHC) (31.4%), professionals' difficulty to reach the place
where patients are treated (8.8 %), insufficient staff / lack of human resources
(4.1%) and use of illicit drugs by patients (3.9%). Blaming the user and the
lack of resources are the main highlights, in addition to issues such as the
professionals' lack of access and knowledge that are highlighted by the
difficulty of patients to adhere to the treatment of tuberculosis according to
the participants' statements. The issues were raised by health workers
manifestations involving adherence to treatment according to the DOT in the
studied health region. It is possible, in this context, to observe the need for
improvement in the knowledge of professionals with regard to the DOT, the
importance of their bond with patients and families and the recognition of the
part of responsibility that belongs to the health team on guaranteeing
treatment.