Tuberculosis among the Xavante Indians of the Brazilian Amazon: an epidemiological and ethnographic assessment.

Autor: Basta PC; Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro (RJ), Brazil., Coimbra CE Jr, Welch JR, Corrêa Alves LC, Santos RV, Bastos Camacho LA
Jazyk: angličtina
Zdroj: Annals of human biology [Ann Hum Biol] 2010 Sep-Oct; Vol. 37 (5), pp. 643-57.
DOI: 10.3109/03014460903524451
Abstrakt: Background: Despite broad availability of a national tuberculosis (TB) control program that has proved effective in Brazil, TB remains a major cause of morbidity and mortality among indigenous peoples.
Aim: We report the results of an interdisciplinary investigation of TB epidemiology, healthcare services, and ethnomedicine among the Xavante Indians of Central Brazil.
Subjects and Methods: Fieldwork components included clinical assessment of TB (479 subjects, 89.3% of the population = 1 year of age), analysis of medical health records, and ethnographic research.
Results: We found TB to constitute a major health risk, with moderately high annual risk of infection (0.94%), moderate prevalence of infection, high percentage of X-ray images suggestive of TB (14.2% in subjects > or = 10 years of age), and a relatively low percentage of individuals with reactive TB skin tests (16.6% of reactions > or = 10 mm) despite high BCG vaccine coverage. We also found a high rate of TB patients showing no evidence of prior infection. Ethnographic interviews show that Xavante and biomedical health perspectives are simultaneously divergent in their etiologies but pragmatically compatible.
Conclusion: Ineffective diagnosis procedures compromise the efficacy of existing TB prevention efforts and threaten to undermine otherwise favorable institutional and cultural conditions.
Databáze: MEDLINE
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