Integração ensino-serviço e o controle da tuberculose na atenção primária à saúde

Abstract

The internship provides a great deal of learning in the doctor's education, and can subsidize the knowledge that will be applied in the care of the person with TB. Objective: To describe the flow of care and knowledge of medical students about the behavior adopted for people with TB in Basic Health Units (UBS) in Fortaleza. Materials and methods: Cross-sectional study, part of the intervention project “Operationalization of Tuberculosis Control in the Basic Health Unit”. It was carried out at the 17 UBS in Fortaleza where students between the 9th and 12th semester of the medical course (internal) are interned. The sample consisted of 82 medical students and 17 health professionals who care for people with TB. The knowledge acquired by the intern during the internship at UBS was verified through a questionnaire on the Google Forms Platform. For the educational intervention, meetings were scheduled via the Google Meet Platform. To identify the care flows for users with respiratory symptoms and those with TB, visits were made to basic health units and a form was applied. Data were tabulated and organized in a Microsoft Excel 2016 spreadsheet, imported into the SPSS version 23 program. The variables were analyzed using descriptive statistics using simple and relative frequencies. Results: Of the 82 inmates, 35.4% (29) had seen a case of TB; 51.2% (42) were unaware of whether the unit performed the Rapid Molecular Test for Tuberculosis (TRM-TB) and 51.3% (42) were unaware of whether the UBS provides PPD. 59.8% (49) did not know who receives the sputum samples, 80.5% (66) did not know where the registration of sputum samples is done and 53.7% (44) did not know how the sputum smear result returns to the UBS. Regarding Directly Observed Treatment (DOT), 42.7% (n=35) do not know where it is performed. As for professionals, 88.2% (15) of participants were nurses and 94.1% (16) said there was no place for sputum collection in the unit. In addition, 88.2% (15) pointed out that the UBS does not perform MRT-TB and that it does not perform PPD, but forwards to another unit (70.6%; n=12). Finally, 47% (8) state that they rarely carry out health education activities about TB. Conclusion: It was concluded that there are weaknesses in the integration of medical interns in the activities of TB in the UBS and, consequently, in the acquisition of knowledge about the flow of care, diagnosis and follow-up of patients with TB in the UBS. Professionals working at the UBS need to have a well-defined flow and the necessary infrastructure for diagnosing patients with TB.