Nutritional status of Kaingáng Indians enrolled in 12 indigenous schools in the State of Rio Grande do Sul, Brazil

The study's objective was to characterize the nutritional status of 3,254 Kaingáng Indians in indigenous schools in Rio Grande do Sul State, Brazil. This was a school-based study. Weight (W), height (H), and waist circumference (WC) were measured according to World Health Organization guidelines (1995). Children's nutritional status classification included H/A, W/A, and W/H according to the National Center for Health Statistics (WHO, 1995) and H/A, W/A, and body mass index/age (BMI/A) according to WHO (2006). Adolescents were classified for BMI/A (WHO, 1995 and 2006) and H/A (WHO, 2006). Adults were classified for BMI (WHO, 1995) and WC (WHO, 2003). Adolescents represented 56% of the sample, children 42.5%, adults 1.4%, and elderly 0.1%. Prevalence rates for stunting were 15.1% (WHO, 1983) and 15.5% (WHO, 2006) in children and 19.9% in adolescents. Prevalence rates for overweight were 11% (WHO, 1983) and 5.7% (WHO, 2006) in children, 6.7% in adolescents, and 79.2% in adults. 45.3% of adults were at increased risk of metabolic diseases. A nutritional transition was observed in the group, characterized by significant prevalence of stunting in children and adolescents and prominent overweight in all age groups.     

Organization and quality of health care for Kaingáng Indians in Rio Grande do Sul, Brazil

This study assesses the health care provided to Kaingáng Indians in Rio Grande do Sul, Brazil. Deaths preventable by primary health care among the Indians and occurring from 1985 to 1995 were compared to the same rates for the State of Rio Grande do Sul as a whole. Secondary data on health care services were supplemented by field interviews with indigenous leaders and with employees from participating institutions. A Geographic Information System (GIS) was used to correlate distribution of deaths and access to health services. The Kaingáng settlements are connected by paved roads to counties with at least a public health clinic or even a small hospital in some cases. Secondary referrals are treated in Palmeiras das Miss?es and Frederico Westphallen and tertiary care is provided in Passo Fundo. What distinguishes the Indian settlements from the rest of the State are the high rates of deaths preventable by primary health care and those related to ill-defined conditions, malnutrition, tuberculosis, and cancer of the uterine cervix.     

Spatial and temporal distribution of tuberculosis in indigenous and non-indigenous of Rondônia State, Western Amazon, Brazil

This study analyzed the spatial and temporal distribution of crude and adjusted rates of incidence of tuberculosis (TB) between 1997 and 2006, identifying areas of greatest risk to the indigenous and non-indigenous population of Rond?nia State, Brazil. An ecological study was conducted analyzing municipalities and Indian reserves, using the local empirical Bayesian method. The crude average rate of incidence of TB among the non-indigenous population was 35.6/100,000 inhabitants, while for the indigenous population it was 415.0/100,000. Rates greater than 600/100,000 were reported in the Karipuna, Sete de Setembro, Igarapé, Ribeir?o and Karitiana reserves. We observed a greater number of cases in under 15 year-olds with little schooling in contrast to the situation in the non-indigenous population. After making adjustments, the rates in some Indian reserves exceeded 240/100,000 inhabitants, while in coinciding municipalities incidence was between the range of 61-120/100,000. The Bayesian method led to decreased overall heterogeneity in rates. Evidence suggests that the indigenous population is more vulnerable to contracting TB and highlighted areas that require further attention to ensure the adequate control of TB in Rond?nia.     

Health evaluation of gold miners living in a mercury-contaminated village in Serra Pelada, Pará, Brazil

Serra Pelada is a village in the Amazon region of Brazil where most of the inhabitants are former gold miners. Of 235 individuals evaluated, 219 were males (93.19%), 16 were females (6.80%), and the mean age was 52.07 years (standard deviation = 11.57). Most were heavy drinkers (62.44%) and smokers (70.30%), and 85.53% had previously suffered from malaria. Reported symptoms included fatigue (30.60%), irritability (35.62%), excitability (14.16%), insomnia (34.48%), memory loss (61.80%), visual field constriction (4.18%), paresthesia (64.93%), partial hearing loss (16.35%), and gingivitis (18.01%). After an examination of the residents, the authors observed several neurological symptoms: tremors (22.80%), involuntary ocular movement (2.20%), visual field constriction (4.18%), Romberg syndrome (2.33%), involuntary tongue movement (2.19%), dysdiadochokinesia (0.43%), failure of a finger-nose test (10.96%), failure of a knee-heel test (4.84%), inability to complete a tandem march (6.25%), muscular weakness (2.27%), and damage to sensory organs (24.66%). The authors concluded that these neurological changes possibly resulted from mercury toxicity; however, they could not determine a significant correlation with the mercury levels detected in participants' urine.     

Spatial distribution of leprosy cases in Ribeirão Preto, Brazil, 2004

This cross-sectional study aimed to describe the spatial distribution of leprosy cases in Ribeir?o Preto in 2004. The data collection was performed through compulsory notification records in the Epidemiological Surveillance Service of the Municipal Secretary of Health of Ribeir?o Preto. The data were geo-coded through the MapInfo program version 7.8 in order to obtain the thematic map. From the 37 cases found, 62% were automatically coded, which revealed good compatibility between the database and the information in the cartographic base. The remaining 38% of the cases were geo-coded interactively. The thematic map analysis and the geo-referenced cases revealed a concentration of cases in the Northern region of the city, traditionally characterized by poor neighborhoods.     

Spatial distribution of the infant mortality rate and its principal determinants in the State of Ceará, Brazil, 2000-2002

The geographic distribution of health problems and its relationship to potential risk factors has opened a vast field for epidemiological research. The present study aims to identify spatial distribution patterns for the neonatal and post-neonatal components of the infant mortality rate (IMR) in Ceará State, Brazil, and discuss the main socioeconomic, demographic, and healthcare factors contributing to the spatial dependence of these components. This cross-sectional ecological study uses multiple linear regression, in which spatial analysis of the components was obtained through the Moran index. Prenatal, childbirth, and neonatal care as well as improved income distribution are decisive for survival in the first month of life, while other factors related to nutrition, immunization, sanitation, education, and economic status are possible determinants of post-neonatal mortality. Selective healthcare measures are known to play a decisive role in decreasing the IMR. However, structural and inter-sector changes generate the sustainability needed to maintain this indicator on the same level as in developed countries.     

Comparison between spontaneous sedimentation method and Paratest® for the diagnosis of intestinal parasitic infections

Correct diagnosis of parasitic infections is essential for the treatment of individuals avoiding indiscriminate use of anthelmintics which increases drug resistance. In a comparative study between the spontaneous sedimentation technique and Paratest^®, 140 stool samples were analyzed for the detection of parasites. The prevalence was 12.7% obtained by the spontaneous sedimentation method but only 5.7% using Paratest^®. Paratest^® has shown a high proportion of false-negative results, lower sensitivity and negative predictive values compared with the spontaneous sedimentation method. Further optimization and studies of the Paratest^® method are necessary for wider use in clinical diagnosis.     

Diagnosis of intestinal amebiasis using coproscopic and immunological methods in a population sample in greater metropolitan Belém, Pará, Brazil

We compare diagnostic methods for Entamoeba histolytica in fecal samples from the city of Belém, Pará, Brazil. We analyze stool samples from children and adults (Group I); stool and serum samples from adults (Group II); and stool samples from children (Group III). In groups I and III, we used direct examination with lugol (DM), Faust et al (FM), and ELISA (detection of E. histolytica anti-GIAP coproantigen) and in group II, DM, iron hematoxylin staining (IHS), FM, ELISA, and the indirect immunofluorescence test (IFAT) for detection of IgG antibodies. Positivity was 10.50% by DM plus FM and 28.99% by ELISA. There was no correlation between positivity and age group. In Group II (n = 87), the positive rate was 4.59% by DM plus FM, 8.04% by IHS, 4.59% by IFAT, and 21.83% by ELISA. The ELISA test was the most sensitive for all groups. IFAT alone is still not a useful tool for diagnosis of E. histolytica infection. The ELISA test is simple, performed in one-third of cases used for IHS and IFAT, and greatly improves quality of diagnosis. We recommend this as the method of choice for diagnosis of suspected E. histolytica infection.     

Evaluation of prenatal care in a micro-regional health system in the State of Ceará, Brazil

This article presents an analysis of prenatal care provided in a micro-regional health system in the State of Ceará, Brazil. The objectives were to analyze the population covered by the Family Health Program (FHP) teams; to evaluate data from the Basic Health Care Information System and the Live Birth Information System; and to establish a profile of medical and nursing services provided during prenatal care. Data were collected from the fourth health micro-region in the town of Baturité and the Ceará State Health Department in May-June 2001, through review of patient records, free observations, and searches in the information systems. Despite the excellent population coverage by FHP teams, resulting in improved access, increased numbers of prenatal visits, improved vaccine coverage, and early diagnosis of complications of pregnancies, the impact of these measures need to be assessed in terms of the real improvement in the women s quality of life. A protocol also needs to be followed by doctors and nurses throughout the course of prenatal care, besides guaranteeing medical consultations as an integral part of the program.     

Breastfeeding experiences of women who work at a textile industry from Ceará, Brazil

This study aimed to understand the experience of women staff employed in a textile industry from Ceara State, Brazil, after returning to work, compared to the process of breastfeeding or weaning. Qualitative research carried out in June 2007 with five working mothers. The stories of these women, from a set of open-ended questions revealed difficulties in reconciling work and breast feeding, because of their beliefs and lack of social and institutional support. The poor conditions of work which these women are exposed are also determining factors in the continuation or discontinuation of breast feeding, being necessary to extend the improvements in institutions with childcare, milk collection places and escorting permanently of these women, when produce their return to work.     

Geographic distribution and epidemiological features of American tegumentary leishmaniasis in old rural settlements in Paraná State, Southern Brazil

This study analyzes the epidemiology of American tegumentary leishmaniasis in the municipalities of the Central North, Central West, and Northwest mesoregions of Paraná State, Brazil. Diagnosis of American tegumentary leishmaniasis cases was performed at the State University in Maringá from 1987 to 2004. According to the probable site of infection, cases were classified as autochthonous (infection inside the household domain) or allochthonous (outside the household domain). Municipalities with the most cases were Maringá (458), Doutor Camargo (126), S?o Jorge do Ivaí (121), Terra Boa (114), Cianorte (98), and Colorado (95). Of the total of 1,938 cases, 66.9% were male. Among the 667 autochthonous cases, similar numbers of men and women were infected, with cases in minors as young as five years of age, with the latter not occurring in the 794 allochthonous cases. Conditions favoring American tegumentary leishmaniasis were created in the processes involved in occupying the rural areas of these mesoregions, particularly in the agricultural settlement model and the crisis in coffee monoculture.     

Physical growth and nutritional profile of the Xavánte indigenous population in Sangradouro-Volta Grande, Mato Grosso, Brazil

This study describes the physical growth and employs anthropometry to assess the nutritional status of a Xavánte indigenous community in central Brazil. Weight, stature, arm circumference, and triceps skinfold were measured in 549 individuals 0 to 90 years of age. Compared to the NCHS reference population, the children presented low height and weight for age, although maintaining body proportionality. Based on WHO criteria, 31.7% of children less than five years presented stunting, while 69.9% of adults presented some degree of overweight. Body composition measures in both genders were situated between the 25th and 50th percentiles of the NCHS reference population until adolescence, when they surpassed the medians. However the mean arm muscle area was consistently above the 50th percentile. The authors call attention to the complexity of the Xavánte epidemiological and nutritional profile, arguing that the study's findings have significant implications for the healthcare system serving this population, in addition to highlighting relevant ecological and socioeconomic issues, particularly in relation to food sustainability and nutritional transition.     

Spatial distribution of M. tuberculosis-HIV coinfection in São Paulo State, Brazil, 1991-2001

OBJECTIVE: To assess the spatial pattern of tuberculosis incidence in relation to the AIDS epidemic, with the aim of investigating the geographical influence on causality. METHODS: All AIDS cases from State of S?o Paulo, notified to the Brazilian Ministry of Health between 1991 and 2001, were included. The cases were stratified by municipality, by administrative health regions, AIDS transmission categories, gender and years since diagnosis. A Gaussian geostatistical model was used to construct a thematic risk map, utilizing the tuberculosis incidence among AIDS cases as the response variable. RESULTS: Exploratory analysis showed two patterns of AIDS incidence: one for the state capital, and another, with increasing risk, for the other municipalities. The more populous regions presented higher risk of tuberculosis transmission, with a pattern that matched the land occupation pattern, from east to west. The health regions with the highest AIDS incidence coefficients (per 10,000 inhabitants) were Santos (53.5), S?o José do Rio Preto (43.1), Ribeir?o Preto (42.4) and S?o Paulo (40.3). The health regions with greatest tuberculosis incidence among AIDS cases were Santos (44.9%), Franco da Rocha (39.9%), Osasco (39.6%) and S?o Paulo (38.9%). CONCLUSIONS: The results allow the conclusion that geographical coordinates presented an association with tuberculosis risk, but not with AIDS risk.     

Mercury exposure in Munduruku Indians from the community of Sai Cinza,State of Pará, Brazil

The objective of this cross-sectional study was to evaluate mercury exposure and health status among Munduruku Indians from the community of Sai Cinza, State of Pará, Brazil. The population studied included 330 indians, who submitted to a questionnaire, clinical exams, and collection of hair, blood, urine, and feces. Mercury was measured in hair and fish. Although no person was found to have overt mercury intoxication, the mean levels of mercury in hair were elevated (14.45 micrograms/g for children from 7 to 12 years old, 15.70 micrograms/g for women between 14 and 44 years old, and 14.1 micrograms/g for the remaining population). Mercury levels in fish were below levels recommended by the World Health Organization, but rates of fish consumption were high. These results place this indigenous populations as a group under risk of mercury toxicity from the gold production.     

Occurrence of Aedes albopictus in the state of Pará, Brazil

It is first reported the detection of Aedes (Stg) albopictus mosquitoes in state of Par , Brazil, in the urban area of Medicil ndia, a municipality far 90 km from Altamira, where 42 adult mosquitoes were baited using human attraction. All mosquitoes were pooled and inoculated into C6/36 and suckling mice in attempts for virus isolation. No virus was isolated. The occurrence of Aedes albopictus in urban areas of the Amazon region is of concern since dengue and yellow fever viruses are endemic in the Amazon and thus there is a potential risk for this mosquito species to become infected with both viruses.     

Mercury contamination of fish and exposures of an indigenous community in Pará state, Brazil

Fish consumption is an important source of protein among indigenous communities in Amazonian Brazil. Exposures to mercury via fish were studied in an indigenous community of the Munduruku reserve, located in the Tapajós River basin in the state of Pará, one of the oldest and most productive gold mining areas in the Amazon region. This study summarizes the results of mercury (Hg) analyses of fish consumed by inhabitants of the Munduruku settlement of Sai Cinza. The most frequently consumed fish, reported by 330 persons interviewed for this study, were tucunaré, pacu, jaraqui, traíra, aracu, matrinch?, and caratinga. The mean mercury concentration in carnivorous fish was 0.297 microg.g(-1) while in noncarnivorous fish mean mercury concentration was 0.095 microg.g(-1). Only in caratinga was there a significant relationship between fish size, weight, and mercury levels. Levels of methylmercury in the tucunaré averaged 0.170 microg.g(-1), while in traíra the mean level of methylmercury was 0.212 microg.g(-1). Although the levels of Hg in fish consumed by the Sai Cinza community are below the Brazilian limit value for consumption, the high rates and amounts of fish consumed by this population are relevant to evaluating risks of mercury contamination for communities with limited food resources.