Factors associated with changes in tuberculosis treatment actions in primary health care in the period 2020-2022; [Fatores associados à alteração das ações de tratamento da tuberculose na atenção primária à saúde no período de 2020-2022]

Ribeiro R.R.; da Silva D.C.; Sthal H.C.; de Oliveira J.A.; Regis I.M.; Hino P.; Oblitas F.Y.M.; Gonzales R.I.C. · Medicina (Brazil) (2025) · DOI: 10.11606/issn.2176-7262.rmrp.2025.226509

Resumen

The Covid-19 pandemic highlighted weaknesses in health systems and impacted access to tuberculosis treatment and monitoring activities at the national and global levels. Objective: to identify factors associated with changes in the tuberculosis treatment activities offered in primary health care settings from 2020 to 2022. Methods: this cross-sectional analytical study examined a random sample of 48 pimary health care units located in the city of Goiânia, Goiás. A structured form with variable response options was used to collect data from October to December 2022, via the Research Electronic Data Capture platform. The descriptive analysis utilized absolute and relative frequencies, and multivariate longitudinal regression analysis was conducted using Stata software, version 17.0. Results: alterations were observed in all tuberculosis treatment activities during the study period (2020-2022). The most significant changes were seen in offers of consultations to monitor treatment and sputum testing orders to assess response. The median rate of change for consultations offered in 2020 was 5 (P25-P75: 0-9), with a mean of 4.39 (SD: 4.30), in 2021 the median rate was 3.5 (P25-P75: 0-8) with a mean of 3.93 (SD: 4.07), and in 2022 the median rate was 0 (P25-P75: 0-2) and the mean 1.79 (SD: 2.84). The median rate of change for sputum testing offered was 2 (P25-P75: 0-8) in 2020, with a mean of 3.89 (SD: 4.17), while the median rate of change in 2021 for this activity was 1.5 (P25-P75: 0-8) with a mean of 3.5 (SD: 3.90), the median rate in 2022 was 0 (P25-P75: 0-3) and the mean 1.72 (SD: 2.77). Astatistically significant association was found between the period investigated for all tuberculosis treatment actions (p<0.000) and the work process for seven of the ten treatment activities Conclusion: The period analyzed (2020 to 2022) and alterations in the team work process were associated with changes in disease treatment activities Thfindings highlight the pressing need for political and management commitments to preserve the elements and supports that are essential for the work process in primary care. Continuing education activities to train and raise awareness among teams must also be intensified in order to effectively resume and strengthen uberculosis treatment activities in primary care.