TUBERCULOSIS IN ROCINHA: ANALYSIS OF INDICATORS AFTER 100% COVERAGE WITH THE FAMILY HEALTH STRATEGY

INTRODUCTION AND OBJECTIVES: Rocinha is a densely populated slum in Rio de Janeiro, Brazil, with approximately 74.000 inhabitants where tuberculosis (TB) control has always been a challenge. In 2010, following Primary Healhcare Reform in the city, Family Health Strategy (FHS) was implemented in the community, with a total of 25 family doctors, 25 nurses, 25 nurse technicians and 150 community health workers. The main objective of this study was to analyze some tuberculosis indicators in Rocinha from 2010 to 2014, following 100% population coverage with FHS and to describe the clinical and epidemiological profile of TB in the community. METHODS: TB Surveillance Information System (SINAN) was evaluated. Data were plotted with Tabwin and analyzed using the statistical package STATA 11.2. RESULTS AND CONCLUSIONS: TB notification by the FHS teams increased from 0.6% in 2010 to 87,3% in 2014. Cure of new smear positive pulmonary cases was 79%, 80.2%, 82.4%, 81.2% and 79,2% in 2010, 2011, 2012, 2013 and 2014, respectively. More than 80% of cases were pulmonary TB. HIV testing increased from 52.4% in 2011 to 87,7% in 2014. Culture performing increased from 37.7% to 58.9%. Mortality rates decreased from 18.7 to 10.1 / 100,000 inhabitants. Contacts evaluation increased from 14.8% to 47,2%. People with TB in Rocinha started to be promptly diagnosed and treated by family doctors in the community, avoiding unnecessary consultation with pneumologists. HIV testing and culture performing improved, while mortality rates decreased. Contact evaluation of tuberculosis patients is increasing but remains a challenge that is strategic to reduce the burden of TB in the community.