O agente comunitário de saúde como facilitador no processo de identificação dos pacientes com hanseníase utilizando análise espacial

Abstract

Leprosy is a chronic, infectious, contagious disease caused by Mycobacterium leprae that mainly affects the skin and peripheral nerves, which can lead to severe physical disabilities and deformities. ACS action has been directed to strengthen the link between the community and the health system, as the basic characteristics of this professional activities of disease prevention and health promotion in the home or community environment. The objective of this study was to analyze the efficiency of the community health agent as a facilitator in the suspicion and mapping of leprosy cases through spatial analysis in the city of Santarém-PA. This is an epidemiological, descriptive, analytical and retrospective study. It is an epidemiological, descriptive, analytical and retrospective study. In the data collection, the cases notified on the basis of the Notification of Injury Information System (SINAN) were used in the period from 2006 to 2014. The census tracts defined by the Brazilian Institute of Geography and Statistics (IBGE) were surveyed and the QUANTUMGIS (QGIS) free software was used in geo-referencing and spatial analysis of the distribution of leprosy cases. mapping of the area covered by the Basic Health Units (BHU) in the urban area of the municipality and identification of the units located in the high and low detection areas of leprosy. The training was carried out for 24 Community Health Agents (ACS), from the selected units in high, medium and low risk area for disease, a questionnaire was applied to measure the information level of these professionals in relation to leprosy and active search was performed during the routine home visit between August and September of 2018 at the BHUs of the neighborhoods Mapiri / libertad, Santa clara and Nova República using the suspected leprosy questionnaire. 311 cases were mapped in the urban area, corresponding to 82.49% of the cases. The spatial distribution was carried out by census tract of the cases reported in SINAN, with the identification of 30 census tracts as hyperendemic and 92 with rates equal to zero, as well as the distribution and identification of the 26 UBS and its areas of coverage, with locations of the units which are in high and low risk areas of leprosy. The misunderstanding and a certain degree of ignorance that the CHWs presented involving basic issues inherent to leprosy revealed the need for permanent health education. During the active search, 19 suspected cases were identified, two of which were discarded making up a total of 17 suspected cases. It is concluded that the use of spatial analysis in the health area is fundamental to subsidize and contribute to the identification of regions that are more vulnerable to the emergence of infectious diseases, such as leprosy, and evidenced the need for investment in training and updating the ACS, with the aim of improving the planning and efficiency of the actions to be developed in the control of leprosy in Santarém-PA.