Temporal trend in the evaluation of adequate management for diagnosis and treatment of tuberculosis in primary health care in Brazil (2012-2018)

Abstract

This study aimed to analyze the presence of infrastructure and adequate work processes in primary health care (PHC) for the diagnosis, monitoring, and treatment of tuberculosis (TB) in Brazil from 2012 to 2018. This is a temporal trend study carried out with data from basic health units (BHU) evaluated in the cycles I (2012), II (2014), and III (2018) of the Brazilian National Program for Improvement of Access and Quality of Basic Care (PMAQ-AB). Variance-weighted least-squares regression was used to estimate annual changes, in percentage points, of the infrastructure and adequate work process of TB in relation to the macroregion, municipality size, Municipal Human Development Index, and Family Health Strategy coverage. The sample consisted of 13,842 BHU and 17,202 health teams in cycle I; 24,055 BHU and 29,778 teams in cycle II; and 28,939 BHU and 37,350 teams in cycle III. There was a gradual improvement in the proportion of infrastructure and work process for TB care over the three cycles of the PMAQ-AB, but none of the sites is fully adequate. The greatest trend of adequate infrastructure was observed in the South Region, and in 2018, 76.5% of the UBS had all the instruments for TB care. The greatest trend of adequate work process was in the North Region, and in 2018, 50.8% of the teams had all the items for TB care. The Brazilian National Program for Tuberculosis Control and the PMAQ-AB have contributed to these advances, but there is still a need to promote public policies that ensure the continuous improvement of TB care in PHC, the effectiveness of TB control and prevention measures.