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Open Access Highly Accessed Research article

Health-service performance of TB treatment for indigenous and non-indigenous populations in Brazil: a cross-sectional study

Everton Ferreira Lemos, Aline Mara da Silva Alves, Giovana de Castro Oliveira, Marcella Paranhos Rodrigues, Natália Daiane Garoni Martins and Julio Croda*

Author Affiliations

Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Rodovia Dourados – Itaúm. Km 12, Dourados, Mato Grosso do Sul 79804-970, Brazil

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BMC Health Services Research 2014, 14:237  doi:10.1186/1472-6963-14-237

Published: 23 May 2014

Abstract

Background

Health-service evaluation studies are fundamental for proposing interventions and ensuring improvements in healthcare quality. The present study assesses the performance of health services for indigenous and non-indigenous populations with regard to tuberculosis (TB) control.

Methods

Interviews with TB patients who underwent treatment between 2009 and 2011 were conducted using the Primary Care Assessment Tool adapted for TB care in Brazil.

Results

Primary healthcare (PHC) was the first treatment for most patients at symptom onset, and the diagnoses were typically performed by specialized services. Many patients experienced delayed TB diagnoses that required more than three medical appointments (51% and 47% for indigenous and non-indigenous populations, respectively). Indigenous people received social support, such as basic-needs grocery packages (2.19 ± 1.63 vs. 1.13 ± 0.49 for non-indigenous people, p < 0.01) and home visits from health professionals, with an emphasis on the performance of directly observed treatment strategies (DOT; 4.57 ± 0.89 vs. 1.68 ± 1.04 for non-indigenous people, p < 0.01).

Conclusions

Regardless of the differences between indigenous and non-indigenous populations, the time needed to receive a TB diagnosis was unsatisfactory for both groups. Furthermore, DOT must be performed with better coverage among non-indigenous patients.

Keywords:
Tuberculosis; Indigenous; Prevention; Control; Health services