03031nas a2200229   4500000000100000008004100001260000800042100003000050700002200080700001700102700002000119700002500139700003100164700002400195700002400219700002000243245008800263250000700351856004800358490000700406520238800413       2022                            d  bRSP1 aSoledad Márdero Garcí G1 aAmorim de Souza E1 ade Araújo V1 aSantos Macedo M1 a Amaral de Andrade R1 aRogers da Silva Ferreira P1 aSoares Guimarães M1 aMenezes da Silva JA1 aRamos Júnior A00aTerritory, neglected diseases and the action of community and endemic combat agents  a27  uhttps://scielosp.org/pdf/rsp/2022.v56/27/en0 v563 a<p>OBJECTIVE: To characterize knowledge, practices, and professional experience of community health agents (ACS) and endemic combat agents (ACE) on leprosy and Chagas disease (DC), during participation in an integrated training workshop in the IntegraDTNs-Bahia project.</p>

<p>METHODS: Descriptive and exploratory case study, involving health agents and endemic combat agents participating in a training workshop on the shared role of these professionals in health care and surveillance processes. The project was developed in the municipalities of Anagé, Tremedal and Vitória da Conquista, in the southwestern State of Bahia, 2019–2020. A specific instrument was applied, with questions related to knowledge and practices of surveillance and care for leprosy and Chagas disease. Descriptive analysis of the data, in addition to consolidation of the lexical analysis, was performed.</p>

<p>RESULTS: Out of a total of 135 participants (107 ACS and 28 ACE), 80.7% of them have been working for at least 12 years, without previous participation in joint training processes. Only 17.9% of endemic combat agentes reported having participated in training on leprosy and none reported developing specific actions to control the disease. For Chagas disease, 36.4% of community health agents participated in training more than a decade before, while for 60.7% of endemic combat agents the last training was carried out in the last five years. The development of educational actions for Chagas disease was more frequent for endemic combat agents (64.3%). When asked about ways of recognizing diseases, the term “skin spots” was the most reported (38 times) for leprosy and, for Chagas disease, the term “I don’t know” (17 times).</p>

<p>CONCLUSION: Processes of health agents and endemic combat agents action in realities endemic for leprosy and Chagas disease in the interior of Bahia proved to be fragmented in the territories. For these diseases, the distance between surveillance and health care actions is reinforced, including in training processes. The importance of innovative permanent and integrated education actions is reiterated to actually promote changes in practices. DESCRIPTORS: Community Health Workers. Neglected Diseases, prevention &amp; control. Leprosy, prevention &amp; control. Health Knowledge, Attitudes, Practice. Primary Health Care.</p>