Active search of patients with respiratory symptoms in tuberculosis control in the Community Health Agents perception

Abstract

The active search of patients with respiratory symptoms is one of the priorities of the National Tuberculosis Control Program. It is expected that this activity must be inserted in the daily work of the Community Health Agents (CHA), in order to find cases precociously. The objective was to analyze the incorporation of case finding (CF) in tuberculosis control in the CHA perception. Data were collected by a survey of laboratory sputum smear results before and after the implantation of CF in the Community Health Agent Program (CHAP) and by an the application of a questionnaire among CHA. After the implantation of CF, the number of sputum smear requests increased in the first two months but decreased in subsequent months. The aspects that may be complicating the sustainability of CF are operational, related to the CHAP's external work (75% CHA experienced difficulties to collect the sputum) and to health service organization (lack of integration between different care points in the health service system: discontinuity in information and communication flows among CHAP and Health Units, strictness in routines/time for sending the sputum to the laboratory). Concluding the family approach is a complex activity demanding that the CHA have a permanent supervision of the nurse or doctor.