Workshop contributes to strengthening Neglected Disease Care Networks

Lines of care refer to the organization of the population service, defining the flow from the smallest municipality to the highly complex service, thus ensuring effective and quality work


Workshop aimed to rebuild care lines for Tuberculosis, Leprosy, Chagas disease, Visceral and Cutaneous Leishmaniasis within the state. The lines of care should bring improvements in health care networks in Piauí

To present to educational institutions, researchers, and health services the proposals for the construction / improvement of care lines for people affected by neglected diseases, as well as the summary report of the critical points for their operation in the state of Piauí. This was the objective of the Workshop on neglected disease care lines, held from October 30 to 31 in Teresina (PI).

At the opening of the seminar, technician Inácio Pereira Lima, the events coordinator, highlighted the importance of discussing the criteria for defining the target audience, the expectation of the technical areas involved and the insertion of the state in the “Piauí Project: Pillars of Growth and Social Inclusion”. He also reaffirmed the foundations of the agreement signed with the World Bank to strengthen actions to control neglected diseases and their burdens. He also underscored the significant gain from working with the support of partner health institutions in Piauí, including the Center for Intelligence in Tropical, Emerging and Neglected Diseases (CIATEN).

For two days, the event, which brought together researchers from across the country, sought to advance the conclusive formatting of care lines for tuberculosis, leprosy, Chagas disease, visceral and cutaneous leishmaniasis within the state. The lines of care refer to the form of articulation of resources and health production practices, guided by clinical guidelines, between the care units of a given health region, for the timely, agile and singular conduction of users by the possibilities. diagnosis and therapy in response to the most relevant epidemiological needs.

Five moments that guided the Workshop were structured. The first was the opening table composed of institutional representatives; the second was a brief contextualization of the INTEGRAR Plan; The third moment was a thematic table for the presentation of the five proposals and lines of care that were followed by debates. The fourth was for group work, and the fifth and last moment was for the presentation of each group and the construction of a consensus agenda.


In the brief context, Herlon Guimarães, Superintendent of Comprehensive Health Care at the State Health Secretary (SESAPI) and Coordinator of the State Center for Coping with Neglected Diseases, stressed that the Workshop will bring gains to the state that will help to address the unfavorable indicators of neglected diseases in Piauí. “With the care lines generated at the event, we expect increased diagnoses, improved patient care, improved patient follow-up during treatment and a safer return for their families. These are proposals that should bring improvements to the states public health services, he concluded.

During the debate, the President of the Brazilian Society of Hansenology (SBH), Claudio Salgado, recalled the importance that neglected diseases should receive. “Many people who suffer from these diseases do not have access to the health care system or can often only perform first-aid care, with a very basic service that sometimes fails to accurately diagnose the patient. With the line of care, we will have an organization of this flow, and bring knowledge to workers of primary care and family health that allow better care and monitoring of the population”, he said. Lucimar Batista, representing the Movement for the Reintegration of People Affected by Leprosy (Morhan), recalled the trajectory of the movement she represents and the difficulties of implementing integrative actions to implement the care lines.

Fernando Sanches, Coordinator of the Infection Control Area of the Brazilian Network for Tuberculosis Research Network (REDE-TB), emphasized that the workshop demonstrated the real concern in outlining a structured, organized, pragmatic and plural plan with the fruitful desire to change the scenario in face of the occurrences of diseases considered neglected. “In unison voices, to combat neglected diseases, not only in Piauí, but also throughout Brazil, we understand that the effort of this Government is more than necessary to spread so that, for example, we can have a continuous call so that other Brazilian states feel influenced by this initiative”, he said. In this sense, according to him, REDE-TB, within its interface on the theme Tuberculosis, joyfully celebrated the participation in this important space to contribute to the process of construction of Tuberculosis care lines in the state of Piauí. It was two days of mutual learning, exchange of experiences, intervention strategies, as well as dialogue between services – government – research – strengthening the gear of Pillars 2 and 3, he added. The product was presented in plenary to the other groups within the neglected disease care lines.

With the participation of representatives of the Chagas disease technical group of the Health Surveillance Secretariat of the Ministry of Health, the team that worked on the Chagas disease care line reviewed important aspects for the state of Piauí. Professor and researcher at the Federal University of Ceará, Alberto Novaes, stressed the importance of the group having the participation, in addition to the state coordinator of the control program, of state (Goiás and Piauí) and national (Instituto Nacional Infectious Diseases – INI / Fiocruz) medical professionals, as well as the coordination of Fiocruz Piauí. Chagas disease as a critically neglected disease demanded this movement to resume the INTEGRAR Plan in the state of Piauí, he stressed by recognizing that this initiative opens an important space for expanding the diagnosis and treatment of people affected by the disease, based on references of the II Brazilian Consensus on Chagas Disease and the Clinical Protocol and Therapeutic Guidelines of the disease. Still according to him, a differential was the possibility of counting on the perspectives brought by the representation of the social movement in Chagas disease, member of FindeChagas.

The group work resulted in important contributions to the improvement of each care line proposal under discussion, which were consolidated and integrated so that after this procedure they are considered validated and approved for application in the state health services network.

The event was also attended by managers and technicians of the Piaui State Secretariat of Health (Sesapi), representatives of local health education, research and service institutions, representatives of the technical areas of health surveillance of the Ministry of Health, researchers linked to postgraduate health programs in Piauí, representatives of social control and professionals of national and state references in each of the diseases under discussion.

The next steps include the layout of the final product containing the five lines in booklet format, and reproduction of two thousand copies for dissemination and distribution to the municipalities of Piauí in partnership with the library of the Federal University of Piauí and the World Bank; the holding of a booklet presentation seminar containing the five lines of care referenced to municipal health managers, scheduled for March 2020; and the training of municipal health managers and technicians of the 224 municipalities of the state in the new formats of health promotion and care to affected people and their families who may become ill with these diseases. This event is scheduled to take place in five classes, aggregating the municipalities by health macro regions, from April to June 2020.