Tuberculin skin test: operational research in the state of Mato Grosso do Sul, Brazil

J Bras Pneumol. 2011 Sep-Oct;37(5):646-54. doi: 10.1590/s1806-37132011000500012.
[Article in English, Portuguese]

Abstract

Objective: To investigate operational aspects of tuberculin skin test (TST) use in tuberculosis control programs and at specialized Brazilian National Sexually Transmitted Diseases/AIDS and Viral Hepatitis Program health care clinics in priority municipalities for tuberculosis control in the state of Mato Grosso do Sul, Brazil.

Methods: This was a descriptive, cross-sectional, epidemiological survey. Data on qualifications/training of professionals administering TSTs, timing of the TST, procedures in cases of loss to follow-up (reading), material availability, and material storage were collected through interviews and technical visits. For the 2008-2009 period, we determined the numbers of screenings in vulnerable populations, of TSTs performed, and of patients treated for latent tuberculosis.

Results: We interviewed 12 program managers in six municipalities. Some programs/clinics did not perform TSTs. Nursing teams administered the TSTs, results were read by non-specialists, and specialization/refresher courses were scarce. The PPD RT23 was stored in 5-mL flasks under appropriate conditions. Insulin syringes were commonly used. Testing was available during business hours, three times a week. In cases of loss to follow-up, telephone calls or home visits were made. Of the 2,305 TSTs evaluated, 1,053 (46%) were performed in indigenous populations; 831 (36%) were screenings in prisons, performed for training; and only 421 (18%) involved contacts of tuberculosis patients or vulnerable populations. Four vulnerable patients and 126 indigenous subjects were treated for latent tuberculosis.

Conclusions: These priority municipalities showed operational difficulties regarding human resources, materials, and data records.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brazil
  • Cities / statistics & numerical data
  • Cross-Sectional Studies
  • Health Workforce / standards
  • Humans
  • Latent Tuberculosis / diagnosis*
  • National Health Programs / organization & administration*
  • National Health Programs / standards
  • Program Evaluation / methods
  • Tuberculin Test / statistics & numerical data*