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Identificação de contactos da pessoa com tuberculose : uma intervenção de enfermagem comunitária
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Advisor(s)
Abstract(s)
A Tuberculose (TB), sendo uma doença tão antiga quanta a espécie humana, mantem-se como uma das principais causas de morbilidade e mortalidade por um agente infecioso em todo o mundo. Esta situação, agravada pela pandemia COVID-19, induziu a que pela primeira vez em mais de dez anos, se tivesse registado um aumento da taxa de mortalidade por esta doença. (World Health Organization [WHO], 2021). Identificar precocemente novos casos da doença, conter a transmissão na comunidade e rastrear as pessoas expostas, para exclusão da infeção latente, estão entre as estratégias essenciais para o controlo da TB, seja a nível nacional como mundial. Assim, é facilmente percetível, que os contactos de uma pessoa com TB constituem um grupo de alto risco. Deverão, como tal, ser orientados para a descoberta sistemática e deteção precoce de casos ativos ou latentes através do rastreio, na persecução do objetivo final que será o início do tratamento ou profilaxia o mais precocemente possível, interrompendo a transmissão da doença e dando cumprimento ao preconizado pelo Plano Nacional para a Tuberculose (PNT). Atrasos na deteção de casos de TB e rastreios de contatos tardios ou incompletos, invariavelmente conduzirão a surtos de TB. O presente documento representa uma recensão reflexiva do projeto de intervenção comunitária desenvolvido numa Unidade de Saúde Pública (USP), na Região de Lisboa e Vale do Tejo, entre 6 de setembro e 18 de dezembro de 2021, e cuja finalidade foi contribuir para a otimização da identificação de contactos, no âmbito do inquérito epidemiológico à pessoa com TB a concretizar pela equipa de enfermagem da USP. Este projeto assenta no Modelo de Promoção da Saúde de Nola Pender e encontra-se suportado na metodologia do Planeamento em Saúde, segundo Tavares (1990), como tal desenvolvido de acordo com as suas etapas e linhas orientadoras. O percurso percorrido, contribuiu e proporcionou o desenvolvimento de competências específicas de Enfermeiro Especialista em Enfermagem de Saúde Comunitária e de Saúde Pública e de Mestre.
Tuberculosis (TB), even though a disease as old as the human species, remains one of the leading causes of morbidity and mortality worldwide by an infectious agent. Such situation has increased by the COVID-19 pandemic which, for the first time in more than ten years, led to an increase in the mortality rate by TB (World Health Organization [WHO], 2021). Early identification of new cases, curtail transmission in the community, and screening those who have been exposed to exclude latent infection are among the key strategies for TB control both nationally and globally. It is quite evident that the contacts of a person with active TB constitute a high-risk group. As such, they need to be oriented towards active contact tracing and therefore early detection of active or latent TB in furtherance of the primary goal of initiating treatment or prophylaxis as early as possible and thereby interrupting the transmission of the disease in compliance with the recommendations of the National Tuberculosis Programme (PNT). Delayed TB index case detection and inadequate or incomplete contact investigation will invariably lead to TB outbreaks. This report represents a critical analysis of the community intervention project developed at a Public Health Unit (USP) in the Lisbon and Tejo Valley Region, between September 6 and December 18, 2021. The focus of this project was to contribute to the optimization of contact tracing within the scope of the epidemiological survey on TB patients carried out by the USP nursing team. This project is based on Nola Pender's Health Promotion Model and is supported by the Health Planning methodology, according to Tavares (1990), and as such is developed according to its phases and guidelines. The path undertaken provided the development of specific competencies of a Nurse Specialist in Community Health Nursing and Public Health Nursing and a master’s degree.
Tuberculosis (TB), even though a disease as old as the human species, remains one of the leading causes of morbidity and mortality worldwide by an infectious agent. Such situation has increased by the COVID-19 pandemic which, for the first time in more than ten years, led to an increase in the mortality rate by TB (World Health Organization [WHO], 2021). Early identification of new cases, curtail transmission in the community, and screening those who have been exposed to exclude latent infection are among the key strategies for TB control both nationally and globally. It is quite evident that the contacts of a person with active TB constitute a high-risk group. As such, they need to be oriented towards active contact tracing and therefore early detection of active or latent TB in furtherance of the primary goal of initiating treatment or prophylaxis as early as possible and thereby interrupting the transmission of the disease in compliance with the recommendations of the National Tuberculosis Programme (PNT). Delayed TB index case detection and inadequate or incomplete contact investigation will invariably lead to TB outbreaks. This report represents a critical analysis of the community intervention project developed at a Public Health Unit (USP) in the Lisbon and Tejo Valley Region, between September 6 and December 18, 2021. The focus of this project was to contribute to the optimization of contact tracing within the scope of the epidemiological survey on TB patients carried out by the USP nursing team. This project is based on Nola Pender's Health Promotion Model and is supported by the Health Planning methodology, according to Tavares (1990), and as such is developed according to its phases and guidelines. The path undertaken provided the development of specific competencies of a Nurse Specialist in Community Health Nursing and Public Health Nursing and a master’s degree.
Description
Keywords
Tuberculose Identificação de contactos Promoção da saúde Enfermagem saúde comunitária Saúde pública Tuberculosis Contact investigation Health promotion Community health nursing Public health