Approach to Tuberculosis from a General Acute Care Hospital in Buenos Aires City as a case study during the COVID-19 Pandemic.

Abstract

Tuberculosis (TB) is an infectious disease historically associated with poverty and unmet basic needs. The persistence of this problem, especially its inequitable distribution, highlights the continued deterioration of the socioeconomic conditions of the population in the working-class neighborhoods of the Buenos Aires Metropolitan Area (AMBA) and the persistence of obstacles to its treatment. Even with the availability of effective pharmacological treatment that enables cure, TB continues to be a public health problem.
The objective of this article is to provide conceptual elements for the analysis of the TB problem and the management strategies at a Public Hospital in the City of Buenos Aires (CABA) during the COVID-19 pandemic. The discussions presented in this paper are based on the results of a research project funded by the National Ministry of Health within the framework of a Salud Investiga grant from 2019 to 2022 (Aranda, Barrios, Otero, et al., 2022; Aranda, Barrios, Pereira, et al., 2022; Pereira, 2021).
First, TB will be contextualized as a health problem in population and epidemiological terms, using secondary sources. The "epidemiological silence" in the inequitable distribution of TB as a health event is problematized. Second, taking into account the dispersion and spatial scope of a public hospital, the case study will be justified as a methodological strategy (Arzaluz Solano, 2005; Martínez, 2017) and the geographic scope will be used to problematize the so-called "territorial policies" in health in the AMBA (Chiara & Moro, 2011). The concept of territory-network and the multi-territorial dynamics characterized by population flows and spatial discontinuity will be reviewed (Haesbaert, 2013, 2019, 2021). Third, based on the recognition of institutional uncertainty as a component in the social process of constructing risky conditions related to TB (Natenzon & Ríos, 2015), a brief identification of the intervening social actors and scale policies will be made (Moore, 2018). Finally, limitations of the process of targeting health interventions, restrictions on mobility, isolation as part of a neo-hygienist logic of surveillance and control during the pandemic period in the AMBA are discussed (Muñoz-Duque & Ortiz, 2023; Palero et al., 2020).