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Tuberculosis control program in the municipal context: performance evaluation.

Tiemi Arakawa1, Gabriela Tavares Magnabosco1, Rubia Laine de Paula Andrade2

  • 1Programa de Pós-Graduação Enfermagem em Saúde Pública. Escola de Enfermagem de Ribeirão Preto. Universidade de São Paulo. Ribeirão Preto, SP, Brasil.

Revista De Saude Publica
|April 6, 2017
PubMed
Summary

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Directly Observed Treatment significantly impacts tuberculosis control program outcomes. Municipalities with higher cure rates and lower abandonment demonstrated better performance, highlighting the need for robust program implementation.

Area of Science:

  • Public Health
  • Epidemiology
  • Health Services Research

Background:

  • Tuberculosis remains a significant global health challenge, necessitating effective control programs.
  • Evaluating the performance of municipal tuberculosis control programs is crucial for identifying areas of success and improvement.

Purpose of the Study:

  • To assess the performance of the Tuberculosis Control Program in municipalities within the State of São Paulo.
  • To identify factors associated with varying levels of program performance.

Main Methods:

  • Ecological study design involving 195 municipalities in São Paulo State (2010 data).
  • Municipalities were grouped based on performance indicators.
  • Multiple correspondence analysis used to associate performance groups with epidemiological, demographic, and health system characteristics.

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Main Results:

  • The worst-performing group had high abandonment rates and low Directly Observed Treatment (DOT) supervision, associated with low TB incidence and high Family Health Strategy (FHS) coverage.
  • The best-performing group showed high cure rates and high DOT utilization, associated with large populations and low FHS coverage.
  • Regular performance groups exhibited intermediate outcomes.

Conclusions:

  • Directly Observed Treatment is critical for successful tuberculosis treatment outcomes.
  • Municipalities' structural and managerial capacities are key to effective Tuberculosis Control Program implementation.