No mundo, mais pessoas morrem de tuberculose que de qualquer outra infecção curável. O Programa Nacional de Controle da Tuberculose (PNCT) tem como propósito fundamental promover o controle da tuberculose no Brasil. Busca a interrupção da transmissão da doença e a conseqüente diminuição dos riscos de adoecer e morrer por ela. Para isso, procura identificar precocemente todos os doentes, garantindo seu tratamento até o final. O Estado de São Paulo, seguindo a política nacional, muito tem investido em treinamentos para implantação da busca ativa do sintomático respiratório. Todos os funcionários de unidades de saúde vêm recebendo treinamentos e todos podem realizar a busca ativa, independente de sua profissão ou função na unidade. Entretanto, em estudo realizado no Município de Guarulhos, em 2005, constatou-se que mais de 90% dos sintomáticos respiratórios deixam de ser identificados pelos serviços de saúde, apesar de que 70% dos profissionais da rede básica de saúde do município receberam treinamento sobre busca ativa em 2004 e a mesma foi implantada em todas as unidades. O objetivo deste estudo foi de conhecer a percepção do profissional de saúde sobre a atividade de busca ativa do sintomático respiratório, no município de Guarulhos, através de entrevistas semi estruturadas e gravadas em fitas magnéticas, utilizando a estratégia metodológica do Discurso do Sujeito Coletivo. Na análise dos discursos ficou evidente que o profissional de saúde sabe o que é fazer busca ativa, a maioria se preocupa com quem está tossindo indo investigar, a atividade é reconhecida como um bom trabalho, é considerada simples apesar de desencadear várias etapas e trazer preocupações e reações tanto do usuário como do profissional de saúde, onde os fatores que inviabilizam a sua execução nas unidades de saúde que fizeram parte deste estudo são: a falta de recursos humanos, excesso de trabalho, falta de interesse e desmotivação aliados à inexistência de uma rotina implantada para que a mesma possa ser realizada. / More people die of tuberculosis than of any other curable infection worldwide. The National Tuberculosis Control Program (NTCP) is involved in the tuberculosis control in Brazil and halting disease transmission and consequently reduce the risk of people getting and dying of tuberculosis. Hence, the early identification is attempted in order to provide complete treatment of all cases. The State of Sao Paulo, in accordance with the National policy, has heavily invested in training professionals to introduce the active case finding of respiratory symptomatics as a routine activity in health care units. All healthcare professionals have been trained and are able to conduct active case findings, independent of their profession or function at the healthcare system. However, in a study conducted in the city of Guarullhos (State of Sao Paulo), in 2005, was observed that more than 90% of respiratory symptomatics are left unidentified in the healthcare units, in spite of 70% of professionals of the whole healthcare system of the municipality having received active case finding training in 2004, when the activity was introduced in all healthcare system. The objective of the present study is to appraise the perception of healthcare workers regarding the active case finding activity in the city of Guarulhos, by means of semistructured tape-recorded interviews, using the methodologic strategy of Speech of Collective Subject. In examining the speeches, it was found out that the healthcare worker is aware of what the active case finding means and most of them are concerned with people coughing and do start the necessary investigations. They recognize that the activity is simple and useful, although comprising several steps. Preoccupations and reactions of both patients and healthcare workers regarding factors that may render the activity not feasible in healthcare units are: lack of personnel, excessive amount of work, lack of interest and motivation added up to non-existing routines that would allow the work to be done.

No mundo, mais pessoas morrem de tuberculose que de qualquer outra infecção curável. O Programa Nacional de Controle da Tuberculose (PNCT) tem como propósito fundamental promover o controle da tuberculose no Brasil. Busca a interrupção da transmissão da doença e a conseqüente diminuição dos riscos de adoecer e morrer por ela. Para isso, procura identificar precocemente todos os doentes, garantindo seu tratamento até o final. O Estado de São Paulo, seguindo a política nacional, muito tem investido em treinamentos para implantação da busca ativa do sintomático respiratório. Todos os funcionários de unidades de saúde vêm recebendo treinamentos e todos podem realizar a busca ativa, independente de sua profissão ou função na unidade. Entretanto, em estudo realizado no Município de Guarulhos, em 2005, constatou-se que mais de 90% dos sintomáticos respiratórios deixam de ser identificados pelos serviços de saúde, apesar de que 70% dos profissionais da rede básica de saúde do município receberam treinamento sobre busca ativa em 2004 e a mesma foi implantada em todas as unidades. O objetivo deste estudo foi de conhecer a percepção do profissional de saúde sobre a atividade de busca ativa do sintomático respiratório, no município de Guarulhos, através de entrevistas semi estruturadas e gravadas em fitas magnéticas, utilizando a estratégia metodológica do Discurso do Sujeito Coletivo. Na análise dos discursos ficou evidente que o profissional de saúde sabe o que é fazer busca ativa, a maioria se preocupa com quem está tossindo indo investigar, a atividade é reconhecida como um bom trabalho, é considerada simples apesar de desencadear várias etapas e trazer preocupações e reações tanto do usuário como do profissional de saúde, onde os fatores que inviabilizam a sua execução nas unidades de saúde que fizeram parte deste estudo são: a falta de recursos humanos, excesso de trabalho, falta de interesse e desmotivação aliados à inexistência de uma rotina implantada para que a mesma possa ser realizada. / More people die of tuberculosis than of any other curable infection worldwide. The National Tuberculosis Control Program (NTCP) is involved in the tuberculosis control in Brazil and halting disease transmission and consequently reduce the risk of people getting and dying of tuberculosis. Hence, the early identification is attempted in order to provide complete treatment of all cases. The State of Sao Paulo, in accordance with the National policy, has heavily invested in training professionals to introduce the active case finding of respiratory symptomatics as a routine activity in health care units. All healthcare professionals have been trained and are able to conduct active case findings, independent of their profession or function at the healthcare system. However, in a study conducted in the city of Guarullhos (State of Sao Paulo), in 2005, was observed that more than 90% of respiratory symptomatics are left unidentified in the healthcare units, in spite of 70% of professionals of the whole healthcare system of the municipality having received active case finding training in 2004, when the activity was introduced in all healthcare system. The objective of the present study is to appraise the perception of healthcare workers regarding the active case finding activity in the city of Guarulhos, by means of semistructured tape-recorded interviews, using the methodologic strategy of Speech of Collective Subject. In examining the speeches, it was found out that the healthcare worker is aware of what the active case finding means and most of them are concerned with people coughing and do start the necessary investigations. They recognize that the activity is simple and useful, although comprising several steps. Preoccupations and reactions of both patients and healthcare workers regarding factors that may render the activity not feasible in healthcare units are: lack of personnel, excessive amount of work, lack of interest and motivation added up to non-existing routines that would allow the work to be done.

Introduction: World Health Organization recommends screening of household contact as a key to improve detection of tuberculosis cases. Ethiopia’s current tuberculosis household contact investigation strategies rely on symptomatic contacts attending health facilities for investigation. This approach has not led to the detection of additional tuberculosis (TB) cases; alternative approaches have to be considered. The purpose of the research was to develop guidelines in endorsing the implementation of a community based household contact investigation program in Addis Ababa. Methods: A mixed method research using sequential exploratory design was conducted in Addis Ababa. In the first phase, qualitative data collection and analysis methods were used to formulate intervention approach and in the second phase, a quantitative random controlled trial was conducted, with the purpose of comparing the proposed intervention measures with routine household contact tuberculosis investigation. Frequencies and logistic regression analyses were used to determine the relative risk and associated factors. Thematic analysis was used for qualitative data analysis. Results: The in-depth interview and focus group discussion findings identified themes namely household contact investigation (HHCI) implementation, misconceptions on HHCI, challenges with HHCI Approaches, opportunities for HHCI provision, contributing factors associated with household involvement, strategies for effective HHCI service and partnerships with health bureau. In phase two, the study reported that the prevalence of TB was 7.1% among the intervention group compared to 1.9% in the control groups at the end of first year follow-up. Nine guidelines were developed to support the household contact investigation system. Conclusion: The passive case detection strategy of contact investigation did not find more cases, and tuberculosis patients and their family contacts were not satisfied with this method. However, the proposed community-based strategy shows that more TB cases can be detected by using existing medical staff. Therefore, an approach that makes the service more accessible is significant and the recommended community based TB household contact tracing approaches needs to be scaled up for its performance towards identified missed cases and enhance patient and their household contacts involvement. / Health Studies / D. Litt. et Phil. (Public Health)