Gonçalves H, da Costa JSD, Menezes A, Leal OF. Adesão à terapêutica da tuberculose em Pelotas, Río Grande do Sul: na perspectiva do paciente . [Adherence to therapy for tuberculosis in Pelotas , Río Grande do Sul: from the patients perspective.] Cadernos de Saúde Pública [Public Health Notebooks] (Rio de Janeiro, Brazil) 1999 October-December; 15(4):777-787.

Objectives: To analyze adherence to treatment for tuberculosis in a group of sick men and women; to observe the effects of the disease on their way of life and on the outcomes of treatment.

Methodology: Ethnographic study. Direct observation and semi-structured interviews.

Results: The tuberculosis program was more than 20 years old. Nevertheless, results in controlling the disease were not satisfactory, because efforts at control were centered on clinical/medical aspects and did not consider the day-to-day lives of tuberculosis patients or the social problem of the disease. In this sense, the main considerations were that the program was free and the treatment ambulatory.

The authors emphasize that the social characteristics attributed to gender are less importance than a series of behaviors that directly affect the manner in which patients struggle with their treatment, their bodies, and the fact that they are sick and must interact socially. Other factors affecting their adherence to treatment are socio-demographic characteristics, cultural factors, popular beliefs, the cost/benefit relationship, physical and chemical effects of medications, the physician-patient relationship, and the degree of participation by the family in the treatment regimen.

Conclusions: Comprehending the factors analyzed in this study is central to understanding the complexity that surrounds the problem of adherence to treatment for tuberculosis. Such understanding should not settle for simplistic answers that blame the patient.