| Full text | |
| Author(s): |
Tiemi Arakawa
[1]
;
Gabriela Tavares Magnabosco
[2]
;
Rubia Laine de Paula Andrade
[3]
;
Maria Eugenia Firmino Brunello
[4]
;
Aline Aparecida Monroe
[5]
;
Antonio Ruffino-Netto
[6]
;
Lucia Marina Scatena
[7]
;
Tereza Cristina Scatena Villa
[8]
Total Authors: 8
|
| Affiliation: | [1] Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto - Brasil
[2] Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto - Brasil
[3] Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Departamento Materno-Infantil e Saúde Pública - Brasil
[4] Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Departamento Materno-Infantil e Saúde Pública - Brasil
[5] Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Departamento Materno-Infantil e Saúde Pública - Brasil
[6] Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Departamento de Medicina Social - Brasil
[7] Universidade Federal do Triângulo Mineiro. Faculdade de Medicina. Departamento de Medicina Social - Brasil
[8] Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Departamento Materno-Infantil e Saúde Pública - Brasil
Total Affiliations: 8
|
| Document type: | Journal article |
| Source: | Revista de Saúde Pública; v. 51, 2017-03-30. |
| Abstract | |
ABSTRACT OBJECTIVE The objective of this study is to evaluate the performance of the Tuberculosis Control Program in municipalities of the State of São Paulo. METHODS This is a program evaluation research, with ecological design, which uses three non-hierarchical groups of the municipalities of the State of São Paulo according to their performance in relation to operational indicators. We have selected 195 municipalities with at least five new cases of tuberculosis notified in the Notification System of the State of São Paulo and with 20,000 inhabitants or more in 2010. The multiple correspondence analysis was used to identify the association between the groups of different performances, the epidemiological and demographic characteristics, and the characteristics of the health systems of the municipalities. RESULTS The group with the worst performance showed the highest rates of abandonment (average [avg] = 10.4, standard deviation [sd] = 9.4) and the lowest rates of supervision of Directly Observed Treatment (avg = 6.1, sd = 12.9), and it was associated with low incidence of tuberculosis, high tuberculosis and HIV, small population, high coverage of the Family Health Strategy/Program of Community Health Agents, and being located on the countryside. The group with the best performance presented the highest cure rate (avg = 83.7, sd = 10.5) and the highest rate of cases in Directly Observed Treatment (avg = 83.0, sd = 12.7); the group of regular performance showed regular results for outcome (avg cure = 79.8, sd = 13.2; abandonment avg = 9.5, sd = 8.3) and supervision of the Directly Observed Treatment (avg = 42.8, sd = 18.8). Large population, low coverage of the Family Health Strategy/Program of Community Health Agents, high incidence of tuberculosis and AIDS, and being located on the coast and in metropolitan areas were associated with these groups. CONCLUSIONS The findings highlight the importance of the Directly Observed Treatment in relation to the outcome for treatment and raise reflections on the structural and managerial capacity of municipalities in the implementation of the Tuberculosis Control Program. (AU) | |
| FAPESP's process: | 12/01802-0 - Performance assessment of tuberculosis control programs in cities of São Paulo State (2006-2010) |
| Grantee: | Tiemi Arakawa |
| Support Opportunities: | Scholarships in Brazil - Doctorate (Direct) |