Detecção de casos de tuberculose e atenção primária: análise da repercussão da pandemia Covid-19
Data
2024-01-12
Autores
Ribeiro, Stephanie 
Orientadores
Hino, Paula
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Identificar a repercussão da pandemia Covid-19 nas ações de detecção de casos de tuberculose no âmbito da Atenção Primária à Saúde no município de São Paulo. Métodos: Estudo de abordagem quantitativa do tipo transversal realizado nos serviços de atenção primária localizados no município de São Paulo. A amostra foi composta por 80 unidades e os representantes foram profissionais de saúde, denominados informante chave, que estavam ativos no serviço desde janeiro de 2020. A coleta de dados ocorreu presencialmente entre dezembro de 2022 a março de 2023 e foi feita por meio de formulário estruturado constituído por variáveis dicotômicas, de múltipla escolha e de escala Likert (0-10) acerca das características das unidades e das ações de detecção da tuberculose durante o período pandêmico (2020-2022). Para análise estatística foi realizada análise descritiva, reportando as medidas de frequência absoluta e relativa, e de associação via Generalized Mixed Models, onde realizou-se a comparação de médias pelo post hoc de Bonferroni. Adotou-se nível de significância de 5% e utilizou-se os programas Jamovi versão 2.3.28 e RStudio versão 4.1.3. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Goiás (parecer no 5.671.976) e Secretaria Municipal de Saúde de São Paulo (parecer no 55.767.166). Resultados: As 80 unidades foram distribuídas proporcionalmente pelas coordenadorias de saúde do município, onde mais da metade dessas era do tipo estratégia saúde da família (53,8%). No período pandêmico houve mudanças especialmente em 2020, com aumento da carga horária (78,8%) e alteração no processo de trabalho (88,9%). A maioria das unidades oferecia diariamente consulta para sintomáticos respiratórios de tuberculose (97,5%), sendo que algumas referiram diminuição da periodicidade dessa consulta (15%). Foi identificado associação entre o período (2020-2022) com alteração na oferta de consulta de sintomáticos respiratórios (p = 0,011) e alteração na notificação dos casos de tuberculose (p = 0,017). Conclusões: Evidenciou-se que a pandemia Covid-19 repercutiu nas ações de detecção da tuberculose no âmbito da atenção primária, sobretudo em 2020.
Objective: To identify the impact of the Covid-19 pandemic on tuberculosis case detection actions within Primary Health Care in the municipality of São Paulo. Methods: A quantitative cross-sectional approach study conducted in primary care services located in the municipality of São Paulo. The sample consisted of 80 units, and the representatives were healthcare professionals, referred to as key informants, who were active in the service since January 2020. Data collection took place in person between December 2022 and March 2023 and was conducted using a structured form consisting of dichotomous, multiple-choice, and Likert scale (0-10) variables about the characteristics of the units and tuberculosis detection actions during the pandemic period (2020-2022). For statistical analysis, descriptive analysis was performed, reporting measures of absolute and relative frequency, and association via Generalized Mixed Models, where mean comparisons were made using Bonferroni's post hoc test. A significance level of 5% was adopted, and the Jamovi version 2.3.28 and RStudio version 4.1.3 programs were used. The study was approved by the Research Ethics Committee of the Federal University of Goiás (opinion no. 5,671,976) and the Municipal Health Department of São Paulo (opinion no. 55,767,166). Results: The 80 units were proportionally distributed by the city's health departments, where more than half of them were of the Family Health Strategy type (53.8%). During the pandemic period, there were changes especially in 2020, with an increase in working hours (78.8%) and changes in the work process (88.9%). Most units offered daily consultation for respiratory symptomatics of tuberculosis (97.5%), with some reporting a decrease in the frequency of this consultation (15%). An association was identified between the period (2020-2022) with changes in the provision of respiratory symptomatics consultation (p = 0.011) and changes in the notification of tuberculosis cases (p = 0.017). Conclusions: It was evidenced that the Covid-19 pandemic had an impact on tuberculosis detection actions within primary care, especially in 2020.
Objective: To identify the impact of the Covid-19 pandemic on tuberculosis case detection actions within Primary Health Care in the municipality of São Paulo. Methods: A quantitative cross-sectional approach study conducted in primary care services located in the municipality of São Paulo. The sample consisted of 80 units, and the representatives were healthcare professionals, referred to as key informants, who were active in the service since January 2020. Data collection took place in person between December 2022 and March 2023 and was conducted using a structured form consisting of dichotomous, multiple-choice, and Likert scale (0-10) variables about the characteristics of the units and tuberculosis detection actions during the pandemic period (2020-2022). For statistical analysis, descriptive analysis was performed, reporting measures of absolute and relative frequency, and association via Generalized Mixed Models, where mean comparisons were made using Bonferroni's post hoc test. A significance level of 5% was adopted, and the Jamovi version 2.3.28 and RStudio version 4.1.3 programs were used. The study was approved by the Research Ethics Committee of the Federal University of Goiás (opinion no. 5,671,976) and the Municipal Health Department of São Paulo (opinion no. 55,767,166). Results: The 80 units were proportionally distributed by the city's health departments, where more than half of them were of the Family Health Strategy type (53.8%). During the pandemic period, there were changes especially in 2020, with an increase in working hours (78.8%) and changes in the work process (88.9%). Most units offered daily consultation for respiratory symptomatics of tuberculosis (97.5%), with some reporting a decrease in the frequency of this consultation (15%). An association was identified between the period (2020-2022) with changes in the provision of respiratory symptomatics consultation (p = 0.011) and changes in the notification of tuberculosis cases (p = 0.017). Conclusions: It was evidenced that the Covid-19 pandemic had an impact on tuberculosis detection actions within primary care, especially in 2020.