Tuberculosis diagnosis and first health service


Diagnóstico da tuberculose e o primeiro serviço de saúde


Diagnóstico de la tuberculosis y el primer servicio de salud



Viroj Wiwanitkit

Wiwanitkit House, Bangkok, Thailand




Sir, the recent report on "tuberculosis diagnosis and first health service" is very interesting 1. Ponce et al. 1 (p. 945) reported that most TB cases were diagnosed in hospital and concluded that "Specialized services were associated with the best diagnostic performance, as opposed to emergency departments, with the worst performance". The great concern related to the reason why the diagnosis of TB in primary care, (which should be the earliest setting for TB diagnosis), is not presently effective and why the quality of diagnosis is not high. In fact, TB is the disease that can be found around the world and it still a global public health threat. Because TB is a chronic disease and the patients can live within their communities with few symptoms and spread the disease to others, the early detection of disease within the community, through primary care and family health teams, seems to be the key for disease control 2. There are several diagnostic tools for TB at present. However, the problem is the availability of such tools at the primary health care center. This obstacle can be due to costs, a and a lack of knowledge among others. Health promotion for the general population is important to encourage a reflection on the possible signs and symptoms of TB. However, the performance of a practitioner with the best diagnostic tool is also equally important in TB management.


1. Ponce MAZ, Wysocki AD, Scatolin BE, Andrade RLP, Arakawa T, Ruffino Netto A, et al. Tuberculosis diagnosis and performance assessment of the first health service used by patients in São José do Rio Preto, São Paulo State, Brazil. Cad Saúde Pública 2013;29:945-54.         

2. Sandhu GK. Tuberculosis: current situation, challenges and overview of its control programs in India. J Glob Infect Dis 2011;3:143-50.         



V. Wiwanitkit
Wiwanitkit House, Bangkhae
Bangkok, Thailand

Submitted on 28/May/2013
Approved on 05/Jun/2013

Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Rio de Janeiro - RJ - Brazil
E-mail: cadernos@ensp.fiocruz.br