Effectiveness of the supervised treatment for the tuberculosis in five brazilian states

by de Abreu, Ricardo Gadelha

OBJECTIVE: To assess the effectiveness of the Directly-observed treatment strategy (DOT) for tuberculosis and the percentage of cure and default in Brazilian municipalities, and to compare the coverage of the Family Health Program (PSF) andthe percentage of cure and default in priority municipalities. METHODS: Ecological exploratory study of geographic clusters, in 114 priority municipalities for tuberculosis in 2004 and 109 in 2005, in the states of Amazonas, Mato Grosso, Pernambuco, RioGrande do Sul and Sao Paulo, using data from the cohort of tuberculosis cases. RESULTS: Porto Alegre presented, in the two years, the lowest percentage of public health clinics with implanted Tuberculosis Control Program and DOT, as well as thelowest coverage of the PSF, however it was not the capital city with the lowest cure proportion in the same period. Similarly, the municipalities of Rio Grande do Sul presented low DOT coverage, but not necessarily the lowest cure and defaultproportions of healing when compared to those of other states in the study. Cuiaba presented the highest DOT coverage among the states? capital cities, and also the highest percentage of cure and lowest default. None of the capital cities reached 85% of cure and 5% of abandonment, targets defined by the Ministry of Health The median cure proportion among municipalities selected in the period in 2005 rangedfrom 63.6% in Pernambuco to 81.7% in Amazonas, in 2004. The median value of the proportion of default ranged from 5.7 in Sao Paulo, 2005 to 11.5% in Mato Grosso, 2004. The lowest coverage of the PSF was in Rio Grande do Sul. CONCLUSIONS:In this study, the largest percentage of cure and the lowest of default were not associated with the DOT strategy