Identificação de lacunas de conhecimento da tuberculose latente e desenvolvimento do PedTB: aplicativo para auxiliar profissionais de saúde a diagnosticar e tratar tuberculose e tuberculose latente na infância

Abstract

Introduction: Children are the ones who fall most ill after tuberculosis (TB) infection, developing so-called primary tuberculosis. Early diagnosis can reduce the mortality rate from this disease, but it is often not done due to the difficulties in achieving it. The increasing number of mobile health technologies can be used to deliver promising results regarding the growth in the diagnosis of active tuberculosis (TB) and latent tuberculosis (LTBI). Although the implementation of this new strategy is expanding over the world, in Brazil it is not yet as widely explored, especially in the pediatric age group. Objective: identify knowledge gaps and attitudes among primary care health professionals regarding the care of LTBI in children and develop an application that would help them diagnose and treat TB and LTBI in childhood. Method: a pilot study of the development and testing of an application prototype that was divided into three main stages: development of the prototype, validation with experts to adjust the initial prototype and assembly of the final version, and application with primary care health professionals. In the statistical analysis, the calculation of averages or average scores was used, in addition to measures of central tendency and dispersion. The Ethics Committee of the Institute of Childcare and Pediatrics Martagão Gesteira approved the project. Results: 24 volunteers who completed the pre-test were interviewed; 20 answered the usability questionnaire. Seven interviewees had previously used cell phone applications and all felt comfortable with this. Regarding knowledge gaps, five of the 24 volunteers (21%) did not know that household contacts should receive treatment to prevent TB; 13 (54%) were unable to answer this question in the absence of the tuberculin skin test. (PT). Everyone agreed that investigating children living in contact with adults with active TB is important and 11 (46%) reported having no difficulties in investigating such contacts; 10 interviewees (42%) believe that parents/guardians do not take contacts in consideration for investigation because they do not understand their importance. The practical procedures for dealing with adverse events in the treatment of LTBI were satisfactory. The application was well accepted and evaluated as easy to use, as no degree of disagreement was observed in any question (SD 0.53 - 1.63) between all questions. Conclusions: The present study demonstrated that the application will be well accepted by primary care health professionals. The majority agree that its use will facilitate the diagnosis of TB and LTBI in childhood and the prescription of treatment. In future work, it will be possible to verify whether the implementation of the application in routine care can contribute to improving the diagnostic capacity of TB in childhood within the scope of primary care.