Hospital morbidity in Suruí indigenous children under ten years old, Rondonia, Brazil, 2000 to 2004

Submitted by Patricia Stilpen ([email protected]) on 2011-04-23T21:57:06Z No. of bitstreams: 1 Morbidade hospitalar em crianças indígenas.pdf: 56446 bytes, checksum: 17546bca224b49f9f192a55ec6d7d7a4 (MD5)Made available in DSpace on 2011-04-23T21:57:06Z (GMT). No. of bitstreams: 1 Morbidade hospitalar em crianças indígenas.pdf: 56446 bytes, checksum: 17546bca224b49f9f192a55ec6d7d7a4 (MD5) Previous issue date: 2007Fundação Oswaldo Cruz. Instituto Leônidas e Maria Deane. Manaus, AM, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Museu Nacional. Departamento de Antropologia. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Objetivos: analisar o perfil de morbidade hospitalar de crianças indígenas atendidas na rede de serviços do Sistema Único de Saúde. Métodos: foram investigados 380 registros de internação hospitalar de crianças indígenas Suruí menores de 10 anos de idade atendidas na rede hospitalar do município de Cacoal, Rondônia, a partir de dados coletados no Hospital Materno-Infantil, instituição pública, e no Hospital Infantil e Maternidade Menino Jesus, instituição particular, no período de 2000 a 2004. Esses dois hospitais concentram o atendimento a indígenas no município.Utilizou-se a Classificação Internacional de Doenças (CID), 10.a revisão, para a classificação dos diagnósticos. Resultados: as doenças do aparelho respiratório - Cap. X (58,2%) figuraram como o principal motivo de internação hospitalar. Doenças infecciosas e parasitárias (Cap I) apresentaram-se como a segunda maior causa (35,0%) e afecções originadas no período perinatal (Cap XVI) como a terceira (3,2%). Outras causas contribuíram individualmente com menos de 1,5% do total, que somadas não atingiram 4%. A maioria das internações (65,5%) foram de crianças <2 anos de idade. O tempo médio de internação foi significativamente superior no hospital público em relação ao privado. Conclusões: o perfil de morbidade hospitalar observado nas crianças Suruí evidencia não somente a precariedade das suas condições de saúde, como também problemas estruturais no que tange às ações de atenção básica. Recomenda-se a realização de estudos que visem aprofundar aspectos epidemiológicos relacionados às internações hospitalares em populações indígenas, fundamentais para o desenvolvimento de ações de saúde mais adequadas.Objectives: to analyze the pattern of hospital morbidity of Suruí Indian children at the local network of the Brazilian Universal Health System. Methods: inpatient data were obtained for 380 children <10 years old hospitalized during 2000 to 2004 at the two hospitals in the city of Cacoal, State of Rondônia, to which Indian patients are referred to Hospital Materno-Infantil (public) and Hospital Infantil e Maternidade Menino Jesus (private). Hospitalization causes were classified according to the International Disease Classification 10th revision. Results: diseases of the respiratory system – Chapter X (58.2%) were the most frequent cause of hospitalization, followed by certain infectious and parasitic diseases - Chapter I (35.0%) and other conditions developed in the perinatal period - Chapter XVI (3.2%). All other causes contributed with less that 1.5% of the total number of admissions, totaling less than 4.0% combined. The majority of hospital admissions (65.5%) were observed in children <2 years old. The average number of hospitalization days was significantly higher in public hospital. Conclusions: the hospital morbidity pattern observed in Suruí children not only discloses their precarious health conditions, but it also points to structural deficiencies at the primary healthcare level. The authors understand that more research is needed to better grasp the epidemiologic background associated with hospitalization causes in Indigenous populations. This information is of paramount value in order to better plan the health interventions aimed at these populations

Nutrition Transition in Amazonia: Obesity and Socioeconomic Change in the Suruí Indians from Brazil

Submitted by Patricia Stilpen ([email protected]) on 2011-04-21T13:43:36Z No. of bitstreams: 1 Nutrition Transition in Amazonia.pdf: 143957 bytes, checksum: 6861cc008fbd86b27e091da6597c5b4f (MD5)Made available in DSpace on 2011-04-21T13:43:36Z (GMT). No. of bitstreams: 1 Nutrition Transition in Amazonia.pdf: 143957 bytes, checksum: 6861cc008fbd86b27e091da6597c5b4f (MD5) Previous issue date: 2008Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro. RJ, Brazil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro. RJ, Brazil.Fundação Oswaldo Cruz. Instituto Leônidas e Maria Deane. Manaus, AM, Brazil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro. RJ, Brazil.The purpose of this study was to assess the nutritional status of the adult Suruı´ population, an indigenous society from the Brazilian Amazon, as it relates to socioeconomic conditions. Fieldwork was carried out in February– March 2005, including 252 individuals (88.1% of the total eligible subjects older than 20 years of age in the villages surveyed). Anthropometric measurements were performed following standard procedures, and percentage of body fat (%BF) was measured by bioimpedance. To classify the Suruı´ according to socioeconomic status (SES), an index was constructed based on a group of variables to characterize socioeconomic differentiation. Evaluated by body mass index (BMI), the majority of Suruı´ 20–49.9 years of age were overweight (42.3%) or obese (18.2%). The frequency of obesity for women (24.5%) was twice that recorded for men. Subjects classified as overweight or obese also showed high %BF and waist circumference (WC). Women in the high SES category showed higher anthropometric values (including weight, BMI, arm fat area, and WC) and %BF than those of lower SES. This study shows that the Suruı´ are undergoing a rapid process of nutrition transition. This transition is closely associated with the emergence of intragroup differences in SES which have impacted diet and physical activity patterns. In research in indigenous peoples in Amazonia, greater attention should be paid to the human biological outcomes of socioeconomic transformations related to the growing involvement of native societies in the market economy. Am. J. Hum. Biol

Nutritional status and anemia in Suruí Indian children, Brazilian Amazon

Submitted by Patricia Stilpen ([email protected]) on 2011-04-24T15:22:34Z No. of bitstreams: 1 Nutritional status and anemia.pdf: 176981 bytes, checksum: 976d877ff63a49c3202298898890339b (MD5)Made available in DSpace on 2011-04-24T15:22:34Z (GMT). No. of bitstreams: 1 Nutritional status and anemia.pdf: 176981 bytes, checksum: 976d877ff63a49c3202298898890339b (MD5) Previous issue date: 2006Fundação Oswaldo Cruz. Centro de Pesquisa Leônidas e Maria Deane. Manaus. AM. Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Rio de Janeiro. RJ. BrasilFundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Rio de Janeiro. RJ. Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Rio de Janeiro. RJ. Brasil.Objective: To assess the nutritional status of Suruí Indian children aged less than 10 years by means of anthropometric measurements and determination of hemoglobin concentration levels. Methods: The study was carried out from February to March 2005 in the Sete de Setembro Indian Reservation, located on the boundary between the states of Rondônia and Mato Grosso, Amazonia, Brazil. Height and weight were measured according to standard procedures and then compared with the National Center for Health Statistics reference values (n = 284). Hemoglobin concentration was determined by a portable ß-hemoglobinometer (Hemocue) (n = 268). Results: The percentages of children £ -2 z scores for height for age, weight for age and weight for height were 25.4, 8.1 and 0%, respectively. For children aged less than 5 years, the percentages were 31.4, 12.4 and 0%. Most children had anemia (80.6%), with a rate of up to 84.0% among those aged 6 to 59 months. Conclusions: There is a high prevalence of protein-energy undernutrition and anemia among Suruí children. Comparison with a previous survey indicated that the prevalence of height for age deficit significantly decreased between 1987 and 2005 (from 46.3 to 26.7% in children younger than 9 years). On the other hand, 3.9% of the children were overweight in 2005, a finding that had not been reported in 1987. The prevalence of anemia did not change remarkably between these years. Despite the improvement in anthropometric parameters, the prevalence of nutritional deficit has been persistently higher than that observed in the Brazilian population at large. It is therefore necessary that systematic and regular monitoring of indigenous children s growth and development be implemented, focusing mainly on nutritional surveillance

Estudo clínico-radiológico de crianças e adolescentes indígenas Suruí, Região Amazônica

INTRODUÇÃO: Entre os Suruí de Rondônia foram registradas incidências médias de TB &gt; 2.500/100.000 habitantes, entre 1991-2002. Aproximadamente 50% desses casos foram notificados em < 15 anos. MÉTODOS: Trata-se de um estudo clínico-epidemiológico que teve como objetivo descrever as características clínico-radiológicas em crianças e adolescentes identificados como contatos de doentes de TB. Além disto, aplicar o sistema de pontuação para o diagnóstico de TB na infância e verificar se as condutas adotadas no nível local foram concordantes com as diretrizes nacionais. RESULTADOS: Foram analisados 52 Rx de 37 indígenas. Deste conjunto, 48,1% foram normais e 51,9% anormais. Alguns dos Rx apresentaram duas ou mais alterações, totalizando 36 eventos independentes. Observou-se infiltrados (38,9%), calcificações (38,9%), cavitações (11,1%) e atelectasias/derrame pleural (11,1%). Nas imagens anormais, 22,2% eram TB provavelmente ativa e 33,3% sequelas. A confrontação com as diretrizes constatou 52,6% de condutas discordantes. CONCLUSÕES: A presença da infecção tuberculosa latente (ITBL) e TB ativa, entre crianças e adolescentes, são indicadores de transmissão ativa e continuada do Mycobacterium tuberculosis. Os Rx mostrando alta frequência de infiltrados e calcificações é compatível com primo-infecção em idade precoce. Entretanto, essas alterações não são diferentes daquelas observadas entre outros grupos, não sugerindo comprometimento imunológico. As discordâncias apontadas indicam que o momento ideal para o tratamento da ITBL passou despercebido. Conclui-se que é fundamental a utilização do sistema de pontuação para o correto diagnóstico de TB na infância, assim como a realização de baciloscopia e cultura de escarro em adolescentes capazes de expectorar

Dental caries and need for dental care among the Baniwa Indians, Rio Negro, Amazonas

Submitted by Patricia Stilpen ([email protected]) on 2011-04-19T13:37:52Z No. of bitstreams: 1 Cárie dentária e necessidade.pdf: 47710 bytes, checksum: 74716254941b5e3365d833a44df279d6 (MD5)Made available in DSpace on 2011-04-19T13:37:52Z (GMT). No. of bitstreams: 1 Cárie dentária e necessidade.pdf: 47710 bytes, checksum: 74716254941b5e3365d833a44df279d6 (MD5) Previous issue date: 2008Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Endemias Samuel Pessoa. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Endemias Samuel Pessoa. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisa Leônidas e Maria Deane. Manaus, AM, Brasil.Universidade Federal do Amazonas. Faculdade de Ciências da Saúde. Manaus, AM, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Endemias Samuel Pessoa. Rio de Janeiro, RJ, Brasil.Pesquisas epidemiológicas em comunidades indígenas no Brasil têm evidenciado forte relação entre a deterioração da saúde bucal e o consumo de itens industrializados (e do açúcar refinado em particular), aliados à precariedade da atenção odontológica. Este estudo abordou a população Baniwa do pólo-base de Tunuí-Cachoeira, São Gabriel da Cachoeira, Amazonas, Brasil. Foi realizado inquérito transversal sobre as condições de saúde bucal, de acordo com critérios da OMS. Foram observadas as condições dentárias e a necessidade de tratamento, examinando-se 590 indivíduos (49,2% da população > 2 anos). A média de dentes atacados pela doença cárie foi 6,0, 8,2 e 22,1 nas faixas etárias 12-14, 15-19 e mais de 50 anos, respectivamente. O maior valor de ceo-d (5,3) foi encontrado na idade de 5 anos. Do total de pessoas examinadas, 73,6% apresentaram alguma necessidade de tratamento cirúrgico-restaurador. Os indivíduos entre 15-19 anos apresentam as mais elevadas freqüências de restaurações. O CPO-D da população Baniwa é elevado, o que deve estar relacionado a processos recentes de mudanças socioeconômicas, particularmente na dieta. Enfatiza-se a necessidade de ampliação da atenção à saúde bucal, considerando-se a complexidade da questão sociocultural dos povos indígenas.Epidemiologic research conducted with Indian communities in Brazil has shown strong correlation between the deterioration of their oral health and the consumption of industrial products, sugar in particular, added to the lack of structure of oral health care. This study was carried out among the Baniwa Indians from the Tunuí- Cachoeira region, São Gabriel da Cachoeira, Northwestern Amazon, Brazil. A cross-sectional survey was conducted according to the criteria established by the WHO, focusing on dental caries and need for dental treatment. A total of 590 individuals were examined (49.2% of the population older than 2 years). The mean numbers of teeth with caries were 6.0, 8.2 and 22.1 in the age groups 12-14, 15-19 and more than 50 years respectively. In children with deciduous dentition the highest mean value of decayed, missing and filled teeth (5.3) was observed in children age 5. From the total of examined people, 73.6% showed some need for surgery-restoration. The individuals between 15-19 years of age show the highest need for restorations. The DFMT index for the Baniwa can be considered high. The results show that it is necessary to expand public health control measures related to oral heath, taking into consideration the complex socio-cultural reality of the Northwestern Amazon region

International Journal for Equity in Health

p. 1-13Introduction: The prevalence of undernutrition, which is closely associated with socioeconomic and sanitation conditions, is often higher among indigenous than non-indigenous children in many countries. In Brazil, in spite of overall reductions in the prevalence of undernutrition in recent decades, the nutritional situation of indigenous children remains worrying. The First National Survey of Indigenous People’s Health and Nutrition in Brazil, conducted in 2008–2009, was the first study to evaluate a nationwide representative sample of indigenous peoples. This paper presents findings from this study on the nutritional status of indigenous children < 5 years of age in Brazil. Methods: A multi-stage sampling was employed to obtain a representative sample of the indigenous population residing in villages in four Brazilian regions (North, Northeast, Central-West, and Southeast/South). Initially, a stratified probabilistic sampling was carried out for indigenous villages located in these regions. Households in sampled villages were selected by census or systematic sampling depending on the village population. The survey evaluated the health and nutritional status of children < 5 years, in addition to interviewing mothers or caretakers. Results: Height and weight measurements were taken of 6,050 and 6,075 children, respectively. Prevalence rates of stunting, underweight, and wasting were 25.7%, 5.9%, and 1.3%, respectively. Even after controlling for confounding, the prevalence rates of underweight and stunting were higher among children in the North region, in low socioeconomic status households, in households with poorer sanitary conditions, with anemic mothers, with low birthweight, and who were hospitalized during the prior 6 months. A protective effect of breastfeeding for underweight was observed for children under 12 months. Conclusions: The elevated rate of stunting observed in indigenous children approximates that of non-indigenous Brazilians four decades ago, before major health reforms greatly reduced its occurrence nationwide. Prevalence rates of undernutrition were associated with socioeconomic variables including income, household goods, schooling, and access to sanitation services, among other variables. Providing important baseline data for future comparison, these findings further suggest the relevance of social, economic, and environmental factors at different scales (local, regional, and national) for the nutritional status of indigenous peoples.Salvado