Tuberculosis diagnostic pathway in a municipality in south-eastern Brazil

OBJECTIVE: To analyse the pathway taken by tuberculosis (TB) patients from the first contact with the health services and the diagnosis of TB disease.

METHOD: In a survey conducted in a south-eastern municipality of Brazil prioritised for TB control, a structured questionnaire was applied to 100 TB patients under treatment; secondary data recorded in two information systems were also collected for analysis. Diagrams were constructed to represent the patient pathway through the health services up to diagnosis.

RESULTS: The emergency services were the point of entry into care for the majority of the patients. Those who first attended primary health care (PHC) centres needed to visit other health services for diagnosis.

CONCLUSION: Our study shows that multiple visits to multiple health services are required for the majority of patients to be diagnosed with TB. It is necessary to reinforce the referral path established for TB diagnosis and communication among providers, who should play a clear role in obtaining early diagnosis.