Avaliação do acesso ao diagnóstico da tuberculose em um município prioritário do estado de Minas Gerais: a perspectiva do doente

Abstract

Despite the advances achieved in recent decades through the improvement of tuberculosis control actions, this disease still persists with high magnitude worldwide. The patient is the central person in terms of disease control actions. Many factors still mystify tuberculosis by patients, such as stigma, fear of death, access to health services, the conduct of health professionals, as well as care that is performed in an impersonal way. Thus, in this work, the objective of this study was to evaluate the performance of interventions established by tuberculosis control policies in primary and specialized care services with regard to access to diagnosis from the perspective of the patient, in the city of Juiz de Fora - Minas Gerais. Cross-sectional study, of an evaluative nature, carried out in primary care and in the specialized service in turberculosis in the municipality, from November 2017 to December 2018. 105 tuberculosis patients participated in the study. The PCATool-Tuberculosis instrument was used in the version of the patients for data collection and they were analyzed in the R program by descriptive statistics and by multiple correspondence analysis of each of the variables referring to the “access to diagnosis” component of the questionnaire. It was possible to verify that the access to the diagnosis presents weaknesses that are related to issues of the health system and the tuberculosis patient, with the first access and discovery of the disease in health services of high technological density, late search by patients for care with health in the perception of illness, difficulties in the early identification of respiratory symptoms by health professionals, as well as successive visits to services to obtain care and diagnose the disease. The study assessed that access to the diagnosis of tuberculosis goes beyond organizational issues in the health system, being influenced by individual determinants of the patient in relation to the illness process. These factors are related to the weaknesses of tuberculosis care services in combating the disease.