As perdas na cascata de cuidado à infecção latente por tuberculose no Brasil sob o prisma dos profissionais de saúde atuantes em estudo de coorte naciona

Abstract

The objective of this study is to understand the reasons for loss of care among contacts of patients with active tuberculosis, from the perspective of healthcare professionals working in a national cohort study. This is a multiple case study with a qualitative, descriptive approach, conducted using three sources of evidence: documents, interviews, and direct observations in two case studies (Manaus and Salvador). Data organization and analysis were performed using AtlasTi® software, which enabled the creation of codes that enabled cross-data synthesis analysis. The analysis strategy was to create a final report that emerged from the cross-referencing of the reports from both cases. The results showed that the reasons for loss of care are the lack of symptoms associated with a lack of knowledge about latent tuberculosis, in addition to stigma. Other reasons, such as lack of time and access to healthcare services, as well as work-related issues, were also identified. It is concluded that the reasons for losses in the care cascade are linked to a lack of awareness of latent tuberculosis, which can be both individual and collective in society. In this context, it is emphasized that more effective approaches to continuing education and health education regarding latent tuberculosis, the care cascade, and its management should be the target of health management, which seeks to implement guidelines aimed at reducing tuberculosis cases in Brazil.