Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 Jun 27;20(6):e0326428.
doi: 10.1371/journal.pone.0326428. eCollection 2025.

Needs assessment and preparedness of the primary health care network for scaling-up preventive tuberculosis treatment in 5 Brazilian capitals

Dinah Carvalho Cordeiro  1   2   3 , Pedro Kuabara  4 , Bruna Chiarini Amaral  4 , Lucas Maia Portugal  4 , Daniel Souza Sacramento  2 , Larissa Rodrigues de Oliveira  3 , Jorgiane da Costa Ferreira Faria  3 , Priscilla Wolter Paolino  3 , Vanessa Cordeiro Vilanova  5 , Mayara de Sá Cavalcanti de Melo  6 , Cristina Bettin Waechter  7 , Anete Trajman  1   3   4   8
Affiliations
Observational Study

Needs assessment and preparedness of the primary health care network for scaling-up preventive tuberculosis treatment in 5 Brazilian capitals

Dinah Carvalho Cordeiro et al. PLoS One. .

Abstract

This study aims to conduct a needs and preparedness assessment of public primary care units to scale up tuberculosis infection diagnosis and tuberculosis preventive treatment in 5 Brazilian capitals. This observational operational study was carried out across five Brazilian high tuberculosis-burden cities. Clinics with at least one monthly new tuberculosis case were included. Data on Purified Protein Derivative (PPD) storage, tuberculin skin testing (TST) and interferon-gamma release assay (IGRA) availability, personnel qualified for performing TST, radiological facilities and tuberculosis preventive treatment drug availability, were gathered between August 2023 and January 2024. Out of 285 clinics included, 78% (CI95%: 73%-82%) did not offer TST on-site, with only 28% (CI95%: 22%3%) having staff qualified to perform TST, and 35% (CI95%: 29%-40%) lacking dedicated refrigerators for PPD storage. Most (97%, CI95%: 94%-99%) clinics did not collect IGRA testing, with an average distance of 6.7 km (CI95%: 5%-7%) to IGRA labs and a turnaround time of 11.7 days (CI95%: 9%13%) for results. Most (87%, CI95%: 83%-91%) do not offer on-site radiological testing. The primary care network was unprepared to scaling up tuberculosis infection testing. Key issues include unavailability of TST mainly because of insufficient qualified personnel. Without accelerated qualification of staff for TST, scaling up tuberculosis preventive treatment will be impossible.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. Dye C, Glaziou P, Floyd K, Raviglione M. Prospects for tuberculosis elimination. Annu Rev Public Health. 2013;34:271–86. doi: 10.1146/annurev-publhealth-031912-114431 - DOI - PubMed
    1. UN General Assembly High-level Meeting on the Fight Against Tuberculosis, 2023. https://www.who.int/activities/preparing-for-the-un-high-level-meeting-o.... 2024 July 15
    1. Political declaration on the UN General Assembly tuberculosis. https://www.who.int/docs/default-source/documents/tuberculosis/political.... 2025 January 10
    1. World Health Organization. Global tuberculosis report. 2023. https://www.who.int/publications-detail-redirect/9789240083851
    1. Alsdurf H, Hill PC, Matteelli A, Getahun H, Menzies D. The cascade of care in diagnosis and treatment of latent tuberculosis infection: a systematic review and meta-analysis. Lancet Infect Dis. 2016;16(11):1269–78. doi: 10.1016/S1473-3099(16)30216-X - DOI - PubMed

Publication types