CONTROLE DA HANSENÍASE NA ATENÇÃO BÁSICA EM SAÚDE NO BRASIL: ANÁLISE DE FATORES DE ESTRUTURA E PROCESSO DE TRABALHO

Abstract

Introduction: Despite advances in recent years, Brazil still ranks second in numbers of new cases of leprosy. The prevalence rate of leprosy has dropped in the last 10 years. However, there are Brazilian regions where this indicator is still high. Brazilian policies were instituted to support the achievement of the goal of the World Health Organization, stating that actions should be expanded for the whole basic health network. Objective: To analyze the association of characteristics of the structure of the Basic Health Units (BHU) and the work process of the Primary Care Teams (EAB) with the coefficient of detection of leprosy in Brazil. Methods: This is an ecological study. We analyzed data from Brazilian municipalities related to UBS structure characteristics and EAB work process. Data were collected from a secondary database of the Brazilian Institute of Geography and Statistics, the United Nations Development Program, the Department of Information Technology of the Unified Health System, the first cycle of the Program for Improving Access and Quality of Basic Care (PMAQ-AB) and the Notification of Injury Information System (SINAN). The 2012 leprosy detection coefficient was considered as the outcome variable. Associations were estimated by means of prevalence ratio (RP) in inflated Poisson regression of zero (ZIP) and respective 95% confidence intervals (95% CI), with a hierarchical approach in four blocks (alpha = 5%). Results: In the adjusted analysis, the variables that showed a significant association with a higher leprosy detection coefficient were: availability of monofilament kit (RP: 1.60, 95% CI: 1.38-1.84), BCG vaccine (RP : 1.15, 95% CI: 1.02-1.32), Directly Observed Treatment (RP: 1.39, 95% CI: 1.15-1.70), minimum time (RP: 1.20, 95% CI (PR: 0.82, 95% CI: 0.70-0.97), and educational actions for leprosy (RP: 1.33; 95% CI: 1.01-1.43); , 11-1,61). CONCLUSIONS: The municipalities with UBS in better conditions regarding the materials and the work process of the EAB, related to the control of leprosy, have a greater detection of cases of the disease, supposedly due to the greater access of the population to the service of health.