TUBERCULOSIS DURING COVID-19: CHANGES IN CARE PROVISION AND DIAGNOSTIC STRATEGIES IN THE MUNICIPALITY OF SÃO PAULO

Tuberculosis remains a public health challenge. Caused by Mycobacterium tuberculosis, it is a socially determined disease, with high prevalence in Brazil, which aims to eliminate the epidemic by 2030, in line with the “End TB Strategy”. The pandemic, however, represented an obstacle, because the redirection of material and human resources compromised care in the country, directly impacting epidemiological indicators. Therefore, the aim of this study is to identify changes in the provision of tuberculosis care between 2020 and 2022. This is a descriptive research study, with a cross-sectional quantitative approach, based on data about tuberculosis care obtained from health professionals who worked directly in disease control during the pandemic. The municipality, which had 468 Primary Health Care Units during the data collection period, had 80 units included and analyzed in the study, based on sample size calculation. Data presentation followed the geographic division of units according to the Regional Health Coordinators. Between 2020 and 2022, in general, regions recorded changes in all strategies, except for the Centro Coordinator, which showed changes only in two categories. It was observed that the main changes occurred in 2020 and 2021, with partial resumption in 2022 in the offer of consultations for symptomatic individuals and those in treatment, sputum request and X-Ray in diagnosis and discharge, medication pickup, and Directly Observed Treatment (DOT). The most affected strategy was DOT, with changes reported by 61.3% of units, followed by the periodicity of medication pickup (45%) and the offer of consultation for respiratory symptomatic individuals (27.5%) in 2020. The findings show that the COVID-19 pandemic affected the provision of services aimed at tuberculosis control in São Paulo, especially in 2020 and 2021, compromising the quality of care offered and contributing to illness in the population. Despite signs of recovery in 2022, the impacts of the pandemic period still reverberate in care indicators.