Integração das ações de vigilância de arboviroses na atenção básica: relato de experiência em um serviço de vigilância em saúde

Abstract

Arboviruses caused by dengue, Zika, and chikungunya viruses represent a major public health problem in Brazil, with an increasing burden of morbidity and mortality in recent years. Historically, surveillance and control strategies focused on the Aedes aegypti vector have been the main technical response to reduce transmission conditions, which should be combined with case surveillance to generate accurate information that supports actions in the territory in a timely manner. With the expansion of primary care in recent years, national recommendations and guidelines for arbovirus control have reiterated the importance of integrating surveillance practices into primary care, especially in the articulation of work processes performed by community agents and endemic control agents, two professional categories created with dissociated work logics. The present study aimed to describe the practical experience in arbovirus surveillance based on the author's work as an endemic control agent (ACE) in a Family Health Clinic in Planning Area 3.3 of the city of Rio de Janeiro. This is an experience report and critical reflection on aspects of the practical integration of arbovirus surveillance in primary care. The experience at the unit revealed significant challenges for the integration process, such as limited human resources, infrastructure, and supplies, low investment in continuing education, noise in relationships between stakeholders due to beliefs and fears regarding changes, the feeling of non-belonging of ACEs in primary care, in addition to the low involvement of the population in health actions. Despite these challenges, the integration of arbovirus surveillance practices between ACEs and ACS within the scope of the Family Health Strategy proved to be feasible and with the potential to improve the effectiveness of transmission control at the local level, through the renegotiation of more agile reporting and investigation flows and better communication among those involved, the development of means of cooperation among workers in the unit, in addition to the sharing of health education activities. It is concluded that the construction of integrated surveillance practices, from a broader perspective, is a process that must be carried out in cooperation, and is everyone's responsibility, in order to provide greater coverage to the actions that permeate the entire health care network.