Memoria CD.indd - ISHAM

Several difficulties have been identified in the care process, ranging from the clinical and laboratorydiagnosis to thel availability of specific medication, which often makes the adherence to treatmenthard to do .Then, we don’t know the real magnitude of PCM, where are the endemic areas, the prevalencerates. The data of incidence and morbidity available today are based on limited reports of clinicalcases and epidemiological investigations.Since 2005, the Ministry of Health, through the Department of Health Surveillance has invested indesigning and implementing the Program for Surveillance and Control of PCM, developed in partnershipwith experts from Teaching and Research Institutions in health.Among the strategic measures for the structuring the Program, these are highlighted:• Development of a surveillance system to know the epidemiological situation, development ofcase reporting, research, control measures.• Organization of the healthcare network, with basic care units and reference hospitals and standardizationof clinical management and provision of medications.• Organization of the Public health laboratories, with adequate infrastructure and equipment,development of technical standards for collecting, packaging and transportation of samples, standardizationof diagnostic methods and acquisition of laboratory supplies;• Training of human resources - physicians, radiologists, pathologists and laboratory techniciansThe surveillance system will be implemented gradually, in eight (8) of the 27 states, which presentshigh prevalence rates of PCM, and have some organization to attend these patients.The activities already taken were the training of technicians of the Public Health Laboratories inmycological and serological diagnosis, standardization of treatment, and the acquisition and provisionof drugs - Itraconazole, Sulfamethoxazole + Trimethoprim for injection, conventional and liposomalAmphotericin B. It is worth to emphasize that all the standardization were based on Brazilian Consensuson Paracoccidioidomycosis prepared by the Brazilian Society of Infectious Diseases, BrazilianSociety of Tropical Medicine and São Paulo Infectious Diseases Society.The main activities planned for 2008 are highlighted below:• Establishment of a technical advisory group for the various systemic mycoses.• Preparation and publishing of clinical and epidemiological protocols for the deployment of surveillancein the states of Paraná, São Paulo, Rio de Janeiro, Minas Gerais, Mato Grosso do Sul, MatoGrosso, Goiás and Rondônia.• Standardization of epidemiological research and information system• Definition of reference health services at the various states• Training of human resources (doctors and technicians surveillance and Lab.)• Drafting Technical Laboratory Manual for diagnosis of Systemic Mycoses• Distribution of the Antigen of P.brasiliensis to standardize diagnosis• Making available Technical Advisors to the states involved• Facilitating technical cooperation with other countries for improving diagnoses97