O controle de comunicantes de tuberculose no programa de controle da tuberculose em um município de médio porte da Região Sudeste do Brasil, em 2002

Abstract

OBJETIVO: Este estudo tem o objetivo de descrever as ações de controle dos comunicantes de tuberculose no Programa de Controle da Tuberculose do Município de São José do Rio Preto (SP), em 2002. MÉTODOS: Estudo descritivo, utilizando dados secundários do Sistema de Informação de Notificação de Tuberculose, prontuários e planilhas de registros do programa de controle da tuberculose. RESULTADOS: Estavam inscritos no programa 166 comunicantes intradomiciliares de tuberculose em 2002, sendo 82 do sexo masculino e 84 do feminino, com maior incidência de casos na faixa etária de 15 e 59 anos (70%); 42 tinham entre 0 e 19 anos (25,3%), 73 entre 20 e 49 anos (44%), e 44 tinham 50 anos ou mais (25,5%). Quanto ao grau de parentesco, 41 eram filhos, 29 companheiros, 22 irmãos e 15 mães do paciente índice. Com relação aos exames solicitados, observou-se que: 12% realizaram baciloscopia e/ou cultura; 100% realizaram radiografia de tórax, e destes, 2 apresentaram suspeita de tuberculose pulmonar e 5 outras afecções; 7,2% realizaram prova tuberculínica, com 4,2% de não reatores e 1,2% com enduração igual a 8 mm. Dos comunicantes examinados, 3 tiveram a doença detectada (1,8%). CONCLUSÃO: O serviço mostrou que não há uma sistematização em relação ao monitoramento do controle dos comunicantes de pacientes com tuberculose.

O programa de controle da tuberculose em Pelotas/RS, Brasil: investigação de contatos intradomiciliares

“…The home contacts in this study were predominantly sons and daughters and spouses/ companions, which characterizes high exposure to bacilli given the proximity and type of relationship with the patient (6) . Age group was predominantly >10 years and adults, which is similar to a study conducted in São José do Rio Preto-SP (9) . Data of the MS (3) show that in Brazil, the disease is most frequently detected in the 25 to 35 age group and there is low incidence in the <10 year age group, although this group is generally more exposed due to the proximity and intensity of contact with the index case (9,14) .…”

“…Age group was predominantly >10 years and adults, which is similar to a study conducted in São José do Rio Preto-SP (9) . Data of the MS (3) show that in Brazil, the disease is most frequently detected in the 25 to 35 age group and there is low incidence in the <10 year age group, although this group is generally more exposed due to the proximity and intensity of contact with the index case (9,14) . Average residents per home in Pelotas-Brazil were 2.9 (12) .…”

“…In light of this scenario, basic care units are the ideal location for contact evaluations, whether by means of community health agents or the family health strategy (5) . Insertion of these professionals in the community facilitates effective assistance and follow-up of contacts, in addition to eliminating the need for transport of these subjects from their home to consultations at the PCT (9) . For this to occur, services must be reorganized with effective operation of reference and counter-reference strategies to optimize communication between the PCT and basic care units.…”

“…Service evaluation studies related to TB contact investigation revealed the absence of systematization in the control of these individuals, although there is standardization of disease control with contacts that is widely advertised in official publications of the Brazilian Ministry of Health (MS) (9)(10) . The organization of family care for smear-positive TB patients is related to compliance with directives established in the national TB control plan (PNCT).…”

“…These directives are based on the evaluation of contacts by means of a protocol with standardizations for requesting and conducting tests, which divides contacts into two age groups, 10 and under and > 10 years and adults (5) . The evaluation of these indicators points to the quality of assistance offered by healthcare services in terms of disease control and TB prevention (9) . This study is relevant due to the epidemiologic situation of TB in Brazil, in RS and the city of Pelotas-Brazil, and the importance of developing TB control actions within the family and, also, the scarcity of research on this topic.…”