Objective The Xavante Longitudinal Health Study was developed to permit granular tracking of contemporary health challenges faced by indigenous communities in Brazil, taking into consideration ongoing historical processes that may be associated with increases in child undernutrition, adult obesity, and cardiovascular disease risks. Methods This was an open‐cohort study with six semiannual data collection waves from 2009 to 2012. The study was undertaken in two Xavante villages, Pimentel Barbosa and Etênhiritipá, State of Mato Grosso, Central Brazil. No sampling technique was used. Data collection placed emphasis on growth and nutrition of children under five and nutrition status, blood pressure, and blood glucose levels of adolescents and adults. Results Baseline data collection began in July/August 2009 with a population census (656 individuals). Between the first and final waves, the study population increased by 17%. At baseline, stunting and wasting was elevated for most age groups <10 years. Overweight, obesity, and increased risk of metabolic complications were expressive among individuals >17 years, disproportionately affecting females. Anemia was elevated in most age groups, especially among females. Mean systolic and diastolic blood pressure was moderate. The overall prevalence of high blood pressure was relatively low. Conclusions Our findings reveal marked health disparities relative to the Brazilian national population and a complex dietary health epidemiology involving the double burden of malnutrition, rapidly changing nutritional indicators, and elevated metabolic disease risk. The topically broad multidisciplinary focus permitted construction of the richest longitudinal data set of socio‐epidemiological information for an indigenous population in Brazil.
BackgroundMalaria constitutes a major cause of morbidity in the Brazilian Amazon where an estimated 6 million people are considered at high risk of transmission. Indigenous peoples in the Amazon are particularly vulnerable to potentially epidemic disease such as malaria; notwithstanding, very little is known about the epidemiology of malaria in Indian reservations of the region. The aim of this paper is to present a spatial analysis of malaria cases over a four-year time period (2003–2006) among indigenous peoples of the Brazilian State of Rondônia, southwestern Amazon, by using passive morbidity data (results from Giemsa-stained thick blood smears) gathered from the National Malaria Epidemiologic Surveillance System databank.ResultsA total of 4,160 cases of malaria were recorded in 14 Indian reserves in the State of Rondônia between 2003 and 2006. In six reservations no cases of malaria were reported in the period. Overall, P. vivax accounted for 76.18 of malaria cases reported in the indigenous population of Rondônia. The P. vivax/P. falciparum ratio for the period was 3.78. Two reserves accounted for over half of the cases reported for the total indigenous population in the period – Roosevelt and Pacaas Novas – with a total of 1,646 (39.57%) and 1,145 (27.52%) cases, respectively. Kernel mapping of malaria mean Annual Parasite Index – API according to indigenous reserves and environmental zones revealed a heterogeneous pattern of disease distribution, with one clear area of high risk of transmission comprising reservations of west Rondônia along the Guaporé-Madeira River basins, and another high risk area to the east, on the Roosevelt reserve.ConclusionBy means of kernel mapping, it was shown that malaria risk varies widely between Indian reserves and environmental zones defined on the basis of predominant ecologic characteristics and land use patterns observed in the southwestern Brazilian Amazon. The geographical approach in this paper helped to determine where the greatest needs lie for more intensively focused malaria control activities in Indian reserves in the region. It also provided a reference to assess the effectiveness of control measures that have been put in place by Brazilian public health authorities.
EL INTERÉS científico por una teoría de la fecundidad basada en la rea-lidad latinoamericana se ha acrecentado en los últimos años (véanse, por ejemplo, los artículos reunidos en [8]). La experiencia con encuestas de fecundidad en nuestros países no ha resultado favorable ante la insufi-ciencia de los esquemas teóricos en los que se basaron [1; 7; 20; 32]. El ensayo presente intenta contribuir a los nuevos esfuerzos de investi-gadores latinoamericanos por construir una teoría de población, con un esquema teórico que introduce ciertas variables económicas para expli-car tendencias y diferencias en el número de hijos por mujer, así como en su espaciamiento y en las otras características que constituyen su ca-lidad. En otro artículo se complementará lo que aquí se plantea con un estudio histórico de la fecundidad en algunos países de nuestro conti-nente, y se pondrán a prueba los conceptos ahora enunciados. II. CONSIDERACIONES GENERALES Tanto la creación de bienes materiales como la creación de personas son procesos de producción: ambas son actividades humanas en las que se transforma un objeto de trabajo mediante la aplicación de medios de trabajo y de trabajo humano [26: 30-44; 30: 130-3; 31: 27]. Ambos procesos tienen como uno de sus resultados entregar un producto del tra-bajo humano. Esta semejanza permite analizar la creación de personas con conceptos económicos. Primero, y siguiendo la innovación de Lancaster [24; 25], un producto de trabajo se define como un vector de caracte-rísticas, o sea, como una combinación de diferentes intensidades de un conjunto de características. Tal definición permite clasificar un producto de trabajo dado según su calidad. Cada grado de calidad reflejaría una * Agradezco a Gustavo Cabrera, losé B. Morelos y Julieta Quilodrán, todos del Centro de Estudios Económicos y Demográficos, sus comentarios, que me permitieron mejorar una versión anterior del presente ensayo. 182
Our objective is to critically review the literature addressing the strategic role of nurses in the daily primary care of arterial hypertension in Indigenous communities in Brazil. We selected studies based on an initial keyword search of major bibliographic indexing databases for the years 2000 to 2020 and manual search. Further selection was based on topical, methodological, and thematic relevance, as well as evaluation of scholarship quality and pertinence to our chosen narrative. The literature demonstrates Indigenous peoples do not receive health services that measure up to national standards in large part due to a marked lack of academic and employer preparation for nurses operating in transcultural settings. Inequities were apparent in recurrent reports of victim-blaming, deficient clinical communication with patients, clinical malpractice, devaluation of hypertension as a problem for Indigenous peoples, insufficient intercultural training for nurses, and discrimination against Indigenous students in nursing education programs. This systemic problem needs to be addressed by universities and the Indigenous Health Care Subsystem in Brazil.
Objective To compare Xavante sociodemographic indicators from six indigenous lands with the non-indigenous population residing in rural areas of four adjacent microregions. Method This is an ecological cross-sectional study, with comparative analyzes between indigenous and non-indigenous residents in the state of Mato Grosso, Brazil. Age and sex structure, literacy rate, income, household sanitation conditions and mortality were compared. Results A total of 14,905 Xavante people and 78,106 non-indigenous people (white, black, yellow and brown) residing in rural areas were characterized. The age structure revealed divergent patterns, 40.0% of Xavante were under 10 years old, against 15.0% of non-indigenous people in the same age group. Regarding non-indigenous people, the Xavante had a higher illiteracy rate (31.3% vs. 9.9%), and 84.1% of the households did not have a bathroom or toilet, 39.6% of Xavante people did not declare an income against 6.5% for the non-indigenous. Conclusion and implication for practice Data on ethnicity, collected for the first time by a census, are essential for demographic analyzes of specific segments of the population, and in the case of the Xavante, they reveal inequalities in relation to non-indigenous people.
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