A saúde da população em situação de rua: repercussões da COVID-19 e tuberculose em Salvador/BA e no Brasil nos anos de 2015 a 2020.

Abstract

Objective: This study aimed to discuss the factors associated with the unsuccessful tuberculosis treatment in the homeless population (HP), between the years 2015 and 2020 in Brazil; and describe how part of the homeless population of Salvador/BA faced COVID-19.Methodology: This is a dissertation composed by two studies: a retrospective cohort epidemiological investigation on the factors associated with the unsuccessful tuberculosis treatment in HP in Brazil, from 2015 to 2020. For this, analysis were developed with individual data of the Information System of Diseases of Notifications of Tuberculosis (SINAN-TB). Analyzes were conducted using Cox regressions between exposure (homeless people), independent covariates, and primary outcome (unsuccessful TB treatment) using RStudio software version 1.4.1717. The second article refers to an experience report on COVID-19 prevention activities in the HP of Salvador/BA between March and September 2020 developed by the group “Nós Nas Ruas”, which was formed by members of the academic community and associates. to the National Movement of the Street Population – Ba (MNPR-BA). The work developed took place through health education practices on risks and disease prevention strategies, combined with emergency actions for the distribution of personal hygiene items. Results: in the manuscript on unsuccessful tuberculosis treatment, it was observed that HP has a higher risk of not completing medical therapy compared to other TB cases. Among homeless people, factors such as mental disorder, illicit drug use and not receiving directly observed treatment (DOT) are associated with unfavorable treatment. As for the second article, approximately 15,800 homeless and socially vulnerable people participated in health education actions against COVID-19, and 8,700 kits with personal hygiene items and 5,000 fabric masks were also distributed. Conclusions: HP is a marginalized segment that suffers from the lack of assistance from society and the public power, which leads to worse health prognoses. In this sense, intersectoral strategies are necessary to qualify TB treatment and mitigate the effects of the COVID-19 pandemic in the PSR. The integration between society, professionals from the social assistance network, the scientific community and the social movement is important to contribute to improving the living conditions of this population segment.