Acompanhamento do tratamento da tuberculose na Atencão Primária à Saúde: revisão integrativa.

Abstract

Tuberculosis is an infectious disease caused by the bacteria Mycobacterium tuberculosis. Although there are strategies to control it, its incidence and mortality are still high, being presented as a public health problem. Even with important changes at the primary health care in the assistance to tuberculosis (TB) patients, there are still fragilities that lead to non-adherence to treatment, what collaborate to persistence of multidrug-resistant strains. Therefore, its morbidity and mortality are mantained, and this impairs the disease control. With regards to the treatment, it consists in the use of an appropriate combination of drugs in correct doses and for long enough. Thus, avoiding the bacterial persistence and drug resistance, so ensuring the patient`s cure. Objective: To present, through the pertinent literature, the way that the Directly Observed Treatment of tuberculosis is done at the Primary Health Care. Methodology: This is an integrative literature review, which enables the synthesis of knowledge and the insertion of the significant results of the main studies, to the practical conducts. For the survey, the SCIELO and BIREME databases were used, and the inclusion criteria for selection were: complete scientific articles published in portuguese, at the last five years (2012-2016), available in full, and pertinent to the topic of this study. The descriptors: "tuberculosis", "treatment", "nursing" and "Primary Health Care" were used. Results and Discussion: 477 publications were found, of which, after using the points of criteria, we identified 12 articles for a detailed evaluation. From the analysis, five categories emerged: the knowledge of the health professionals about tuberculosis and the Directly Observed Treatment; challenges to the realization of the Directly Observed Treatment; the multidisciplinary team to treat tuberculosis; the need for continuous education directed to the care of TB patients; and the recommendations for the professional practices on the Directly Observed Treatment of tuberculosis. We observed fragilities on the integral attendance, revealing the need to forming a multidisciplinary team for the care of TB patients; was also evidenced the presence of factors related to both, patient and professional, that lead to non-adherence to treatment; and the professionals demonstrated a lack of knowledge about the disease, pointing to the importance of the continuous education, and training for the team of the Primary Health Care, in order to improve the activities of education and health care. Final Considerations: The study evidenced that the professionals working at the basic health attention, including nurses, need more instruction to deal with TB patients, being able to offer guidance, integral care, assistance and adequate supervision of the treatment, involving a multidisciplinary team, aiming at the quality of care and the health promotion.