Introduction: Primary Health Care (PHC)is the gateway for respiratory symptomatics (RS) for tuberculosis (TB) in Brazil,RS being the individual with a cough for at least three weeks. Until the current moment, Brazil is the 20th in the list of 30 priority countries for TB control, following the targets for the World Health Organization (WHO) quinquennium 2016-2020. There is an evident need to combat the disease: there is an incidence rate of 33.5 / 105 inhabitants (2017), new cases, and an average treatment abandonment of 10.55% (2001-2016, MS). Thus, the National Tuberculosis Control Program (PNCT, in portuguese), instituted in 2004, aims to decentralize and horizontalize the actions of TB surveillance, prevention and control and bases its actions upon parameters of the prevalence of SR symptomatic in the population. The PNCT is a great ally in the fight against TB in Brazil.
Objective: To analyze the importance of PNCT implementation in the management and treatment of tuberculosis in Primary Health Care in Brazil.
Results And Discussion: The PNCT, between 2004 and 2007, received 120 million reais from the Federal Government. The program promoted 313 refresher courses, reaching approximately 58 thousand SUS health care professionals, and hired 30 consultants to strategically plan their actions. The access door most used by users of the Unified Health System (SUS) for thediagnosis of TB is Basic Care. In Vitória, Espírito Santo, 63% of the TB casesdiagnosed were found in the Family Health Units(FHU) and another 10% in the UBS, totalizing over 70% of all TB diagnosis. These data, when added to the results of the implementation of PNCT, which brought decentralization in the process of active search and reception,diagnosis and treatment of the patient/SUS user with signs and symptoms relatedto tuberculosis, reinforce the importance of Primary Care in the process of attempting to cure this individual. After decentralization via PNCT in Dourados, Mato Grosso do Sul, the number of RS examined increased by 81.58% between 2003 and 2006. In the same city, the proportion of cases of smear-positive pulmonary TB increased from 38.4% to 71.6%, and the percentage of TBcases detected among the total estimated cases increased from 47.6% to 61.2%, both in the same period. The percentage of health services that implemented the Supervised Treatment Strategy (TS-DOTS) went from 7% in 2000 to 81% in 2006. Between 2001 and 2017, the incidence rate of new TB cases dropped from 42.8 to 33.5/100 thousandinhabitants. Between 2001 and 2016, the mortality coefficient of the disease fell from 3.1 to 2.1/100 thousand inhabitants. In addition, Brazil has established partnerships for the control of the disease, such as a cooperation plan with the BRICS.
Conclusion: The National Program for Tuberculosis Control has brought significant progress, among which we highlight the greater control of data, improvement of cure indicators, reduction of incidence and increase of adherence to treatment. However, the disease continues to be an important public health problem and social marker, which reiterates the need to strengthen existing strategies and create new ones, seeking to promote improvements in the health and quality of life of the population.
