Recuperando o fôlego: a importância das equipes de atenção primária prisional para o controle da tuberculose nos presídios do estado do Rio de Janeiro

Abstract

The right to health in Brazilian prisons is a historical challenge, marked by significant morbidity, especially from infectious diseases such as tuberculosis. The National Policy for Comprehensive Health Care for the Deprived of Liberty Population in the Prison System aims to ensure access for this population to comprehensive care within the Unified Health System (SUS) throughout their prison journey, through the establishment of Prison Primary Care teams (PNAISP). The main objective of this study was to analyze the importance of implementing Prison Primary Care teams in controlling tuberculosis in the prison system of the state of Rio de Janeiro. Specifically, I sought to describe the process of implementing the Prison Primary Care teams in the state and to relate the implementation of these teams to two operational tuberculosis indicators: the confirmation of tuberculosis diagnosis by laboratory criteria and HIV testing among new tuberculosis cases. To this end, documentary research was conducted, combining qualitative analysis of institutional documents and quantitative analysis of operational data. It was found that the state of Rio de Janeiro adhered to PNAISP in 2014, but only in 2019, with the creation of a specific superintendency within the structure of the State Health Department of Rio de Janeiro, did efforts begin to implement the policy in municipalities with prison units, especially through the establishment of a co-financing program for municipalities. By 2024, all penal units in the state of Rio de Janeiro were covered by Prison Primary Care teams. An increase was observed in both evaluated indicators: the percentage of confirmation of pulmonary tuberculosis by laboratory criteria and the percentage of new tuberculosis cases that underwent HIV testing. This study sought to demonstrate that decentralizing health care for the deprived of liberty population to Primary Health Care in the penal units of the state of Rio de Janeiro was fundamental in initiating a paradigm shift in tuberculosis control within the state’s prisons.