Action plan for the control of tuberculosis

Introduction.Tuberculosis is a highly prevalent disease in the poor urban surroundings of Sao Paulo, but diagnosis is often late, leading to difficulties in the control of the disease.
Objectives. The purpose of the present study was to evaluate the effect of an action plan for the diagnosis of pulmonary tuberculosis, implemented in a primary healthcare facility in Sao Paulo, designed according to the guidelines of the Brazilian Ministry of Health
Material and methods. The action plan included education of health professionals, active search of patients with respiratory symptoms (home visits), creation of a fluxogram for the investigation of patients with respiratory symptoms with spur examination for those cases with cough for longer than three weeks. Data was retrieved from the official books for registry of suspected and diagnosed cases. Data between 2004/2005 was compared to those from 2006/2007; since it refers to the whole population living in a delimited area, statistical tests were not performed.
Results. There was an increase of 70% in the number of persons investigated for respiratory symptoms (88.760 vs. 150.164), 250% in the number of persons diagnosed with prolonged cough (238 vs. 685). There was a three-fold increase in the diagnosis of pulmonary tuberculosis (8 vs. 26 cases), as 88% had positive spur exam for Mycobacterium. Cure rate was 100% with no cases of abandonment of treatment and all cases were investigated for the association between tuberculosis and HIV.
Conclusion. The action plan was highly efficient for the diagnosis of new cases of pulmonary tuberculosis, thanks to the mechanisms of active search of individuals with prolonged cough.