Adherence to Tuberculosis Treatment: Programatic Vulnerability Elements

Abstract

Introduction: Tuberculosis remains as a serious public health problem, and the current challenge is to find effective solutions that facilitate adherence to the treatment. Objective: Describe the distribution of the adhesion markers scores to treat tuberculosis, related to aspects of programmatic vulnerability.  Methods: This is a cross-sectional study with a quantitative approach, which included 39 patients with tuberculosis, developed in the city of Campina Grande, Paraíba, Brazil. Data were collected in March 2015, through a structured interview with an instrument containing 32 adherence markers, applied in the reference clinic for tuberculosis or in the patient’s residence. A descriptive analysis was performed using 12 markers expressing programmatic vulnerability elements, divided into two areas: structure and dynamic aspects of health services organization, and implementation of actions. Results: It was observed similar patterns of scores distribution in the two axes of analysis, with higher medians and larger variations to score 3. The markers that showed more score 1, implying in a low adherence potential, were ‘patient’s residence visit’, ‘time for diagnosis’ and ‘treatment difficulty relative to the public health system’. The more positive contribution on the potential accession was the bond markers. Conclusion: The distribution of scores pattern shows to be related to the centralized attention model to tuberculosis adopted by the municipality, and suggests the interconnection of the markers.