Introduction Since establishment of DOTS Strategy in 1998, the Sao Paulo State TB Control Program has always been emphasising the need to sensitise and train healthcare workers (HCWs) in primary care with the purpose to expand and strengthen DOTS in TB high burden municipalities aiming the decentralisation of TB care.
Method Two TB burdened metropolitan regions were chosen for TB Training: (a) Metropolitan Area of Sao Paulo (approximately 20 million inhabitants) and (b) Sao Paulo Atlantic Coast (approximately 2 million inhabitants) with 18 high TB burden municipalities. Sao Paulo State has a huge population distributed in its 645 municipalities with 73 high TB burden cities. The training model used a framework consisting of classes and workgroups for 5 workdays (20 h), with a participative methodology to propitiate an interaction between trainees and tutors generating discussions and allowing the consensus in TB-related matters.
Results The training activities took place in 2010 sponsored by Sao Paulo State Secretary of Health and Global Fund TB Brazil. The TB training has been accomplished successfully with 1256 HCWs from May to October 2010. The 2009 epidemiological evaluation achieved active case findings rates from 0.9% to 126.6% of goal which is to examine 1% of inhabitants of each municipality, and treatment coverage rates on DOT from 7.8% to 96.8%, demonstrating the need of improving rates in some TB high burden municipalities regarding TB trainings of HCWs.
Conclusions Training activities must be understood as a planning and follow-up resource in order to improve TB control activities.