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Factors associated with death among indigenous and non-indigenous pregnant and postpartum women hospitalized for COVID-19 in Brazil. 巴西因COVID-19住院的土著和非土著孕妇和产后妇女死亡相关因素
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-01 Epub Date: 2024-05-02 DOI: 10.1590/1413-812320242912.07432024
Adryelle Katheline D'Elia de Moura, Glênio Alves de Freitas, Renata Palópoli Pícoli

The present article aimed to analyze the association between sociodemographic and hospitalization characteristics with the outcome of indigenous and non-indigenous pregnant and postpartum women, as well as factors associated with deaths among indigenous women hospitalized for Severe Acute Respiratory Syndrome (SARS) due to COVID-19 in Brazil. This is a cross-sectional and analytical study, with secondary data of pregnant and postpartum women of reproductive age, classified into race/skin color (indigenous and non-indigenous), extracted from the Obstetric Observatory, which uses data from the Influenza Epidemiological Surveillance Information System. The outcome variables were analyzed using the chi-square test or Fisher's exact test, and logistic regression was performed for the factors associated with the death of indigenous people. The highest proportion of deaths occurred among non-indigenous women who were in the 2nd trimester of pregnancy (99.7%), who lived in urban/peri-urban areas (99.8%), as well as in the South/Southeast (99.8%) and Northeast (99.5%) regions. Indigenous people who lived in rural areas and in the North and Midwest regions have a greater chance of death when compared to indigenous people who lived in urban areas and in the South/Southeast regions.

本文旨在分析巴西因COVID-19导致的严重急性呼吸系统综合征(SARS)住院的土著妇女的社会人口学和住院特征与土著和非土著孕妇和产后妇女预后之间的关系,以及与死亡相关的因素。这是一项横断面和分析性研究,从产科观察站提取了按种族/肤色(土著和非土著)分类的育龄孕妇和产后妇女的次要数据,该观察站使用流感流行病学监测信息系统的数据。结果变量采用卡方检验或Fisher精确检验进行分析,并对与土著居民死亡相关的因素进行logistic回归。死亡比例最高的是非土著妇女,她们处于妊娠第二阶段(99.7%),生活在城市/城郊地区(99.8%)以及南部/东南部(99.8%)和东北部(99.5%)地区。与生活在城市地区和南部/东南地区的土著人民相比,生活在农村地区和北部和中西部地区的土著人民死亡的机会更大。
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引用次数: 0
Body composition versus anthropometric results of the Khisêdjê Indigenous of Xingu - MT/Brazil. 巴西新古- MT/ Khisêdjê土著人的身体组成与人体测量结果。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-01 Epub Date: 2024-04-05 DOI: 10.1590/1413-812320242912.05862024
Lalucha Mazzucchetti, Patrícia Paiva de Oliveira Galvão, Mário Luiz da Silva Tsutsui, Kennedy Maia Dos Santos, Douglas Antônio Rodrigues, Vânia Fernandes Rabelo, Suely Godoy Agostinho Gimeno

This study aimed to evaluate the body composition of the Khisêdjê, an Indigenous people residing in the Xingu Indigenous Territory, and compare it to the results obtained by anthropometry. One hundred seventy-nine individuals aged above 20 of both genders were included. The nutritional status was classified per the cutoff proposed by the WHO (1995). The body composition was identified using measures derived directly from a bioelectrical impedance device (resistance - R, reactance - Xc, and phase angle - PA). Data were analyzed using the Student t-test, chi-square, Pearson correlation, and analysis of variance, and 57% of the sample was male. The mean age of the population was 37.5 years, and 48% of subjects had some overweight level (BMI ≥ 25,0 kg/m2). We identified a positive correlation between BMI with waist (WC) and arm (AC) circumference, and PA measurements, and an inverse correlation between BMI and R and Xc measurements. R and Xc mean values decreased with increasing BMI. In contrast, mean PA increased with greater weight. The results suggest that being overweight among the Khisêdjê Indigenous people was associated with higher muscle mass amounts.

本研究旨在评估居住在新古土著领地的土著居民Khisêdjê的身体成分,并将其与人体测量结果进行比较。年龄在20岁以上的男女共179人。营养状况根据世界卫生组织(1995年)提出的临界值进行分类。体成分是通过生物电阻抗装置(电阻- R,电抗- Xc,相位角- PA)直接测定的。数据分析采用学生t检验、卡方检验、Pearson相关和方差分析,57%的样本为男性。人群平均年龄为37.5岁,48%的受试者有一定程度的超重(BMI≥25,0 kg/m2)。我们发现BMI与腰围(WC)和臂围(AC)以及PA测量呈正相关,BMI与R和Xc测量呈负相关。R和Xc平均值随BMI的增加而降低。相比之下,平均PA随体重增加而增加。研究结果表明,Khisêdjê土著人的体重超重与较高的肌肉量有关。
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引用次数: 0
Living conditions, nutrition, and maternal and child health in the Baniwa Indigenous people, Northwest Amazon, Brazil. 巴西亚马逊西北部巴尼瓦土著人民的生活条件、营养和妇幼保健。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-01 Epub Date: 2024-04-25 DOI: 10.1590/1413-812320242912.07152024
Hernane Guimarães Dos Santos Junior, Aline Alves Ferreira, Mirian Carvalho de Souza, Luiza Garnelo

Epidemiological surveys by ethnic groups are scarce in Brazil. The health and nutrition conditions of indigenous peoples who face situations of social inequities and inequalities, negatively influence their health indicators. This study is the widest investigation on the subject ever carried out on the Baniwa ethnic group, one of the most numerous in the country. The survey aimed to analyze the living conditions and nutritional profile of children aged under 60 months and women aged 14 to 49 years of the Baniwa ethnic group, residing in the northwest region of the state of Amazonas, in the Indigenous Land of Alto Rio Negro, an area that serves as a border connecting Brazil, Colombia, and Venezuela. The results show a high prevalence of chronic malnutrition in 52.5% (95%CI 48.9-56.1) and anemia in 68.3% (95%CI 64-5-71.8) of children under 60 months, in addition to overweight in 26.3% (95%CI 18.4-27.0) and anemia in 52.3% (95%CI 43.6-53.6) of the women. The situations of food insecurity observed in this study are linked to poor income and sanitation conditions. The magnitude of these injuries expresses the low effectiveness of primary care actions offered by the health system, with a significant percentage of hospitalizations resulting from injuries sensitive to basic care at the primary care level.

在巴西,按民族进行的流行病学调查很少。面临社会不平等和不平等状况的土著人民的健康和营养状况对其健康指标产生不利影响。这项研究是对该国人数最多的巴尼瓦族进行的最广泛的调查。该调查旨在分析居住在亚马孙州西北部阿尔托巴布内格罗土著土地上的巴尼瓦族60个月以下儿童和14至49岁妇女的生活条件和营养状况,该地区是连接巴西、哥伦比亚和委内瑞拉的边境地区。结果显示,60个月以下儿童慢性营养不良发生率为52.5% (95%CI 48.9-56.1),贫血发生率为68.3% (95%CI 64-5-71.8),此外,妇女超重发生率为26.3% (95%CI 18.4-27.0),贫血发生率为52.3% (95%CI 43.6-53.6)。本研究中观察到的粮食不安全状况与收入和卫生条件差有关。这些伤害的严重程度表明卫生系统提供的初级保健行动的有效性较低,由于对初级保健一级的基本护理敏感的伤害而住院的比例很高。
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引用次数: 0
The meanings of differential health care given by health professionals of the Alto Rio Negro DSEI-AM, Brazil. 巴西Alto里约热内卢Negro DSEI-AM保健专业人员对差别保健的意义。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-01 Epub Date: 2024-04-25 DOI: 10.1590/1413-812320242912.07052024
Maria Rosineide Gama Feitosa, Ana Lucia de Moura Pontes

This article discusses the meanings of differentiated health care guideline given by health professionals from the Indigenous Health Multidisciplinary Team (EMSI) who work at the Alto Rio Negro Special Indigenous Health District (DSEI-ARN). This exploratory, descriptive, analytical, and qualitative study conducted 15 semi-structured interviews with professionals from the Indigenous Health Multidisciplinary Teams of the DSEI-ARN, which were submitted to content analysis. The four meaning cores identified from the analyses were: Differentiated care as a way of providing primary care in the territory; Actions conducted under the population's cultural differences; Self-care, traditional medicine, and the construction of therapeutic itineraries; and Professionals' challenges and difficulties in addressing traditional indigenous health care. In the professionals' perspective, differentiated health care is linked to the conditions for working in this primary care type. For their performance, they refer to the need to respect the cultural differences of the Indigenous population. Professionals recognize the use and effectiveness of Indigenous practices, knowledge, and regional specificities.

本文讨论了在Alto里约热内卢黑人特别土著卫生区(DSEI-ARN)工作的土著卫生多学科小组(EMSI)的卫生专业人员提供的差异化卫生保健指南的意义。这项探索性、描述性、分析性和定性研究对来自DSEI-ARN土著卫生多学科小组的专业人员进行了15次半结构化访谈,并将其提交给内容分析。从分析中确定的四个意义核心是:差异化护理作为在领土上提供初级保健的一种方式;在人口文化差异下采取的行动;自我保健、传统医学和治疗行程的构建;专业人员在处理土著传统保健方面面临的挑战和困难。从专业人员的角度来看,差别保健与这种初级保健类型的工作条件有关。对于他们的表现,他们指的是需要尊重土著居民的文化差异。专业人员认识到土著实践、知识和地区特色的使用和有效性。
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引用次数: 0
Sociodemographic profiles of Indigenous households in the 1991, 2000, and 2010 censuses. 1991年、2000年和2010年人口普查中土著家庭的社会人口概况。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-01 Epub Date: 2024-04-22 DOI: 10.1590/1413-812320242912.13382023
Leandro Okamoto da Silva, Cleber Nascimento do Carmo, Ricardo Ventura Santos

This article analyzes the sociodemographic composition of the Indigenous population in Brazil in the 1991, 2000, and 2010 demographic censuses, in addition to investigating inequalities in access to basic sanitation and electricity based on the 2010 Census. A methodology is proposed that classifies households with Indigenous residents as "homogeneous", "mixed" with an Indigenous in the category "household head", and mixed with a non-Indigenous in the category "household head". Regional and situational differences overlapped with differences by type of household and location, with better conditions in urban than rural areas and in the Southeast and South. The North was the region with the least access in general. Regional differences and differences between urban/rural areas were observed, highlighting better urban conditions in the Southeast and South. These inequalities reflect fragmented public policies, economic pressures, and deterritorialization, among other factors. The development of new techniques and critical debate is essential to understanding and addressing racial inequalities in the country and promoting public policies appropriate to Indigenous peoples.

本文分析了1991年、2000年和2010年巴西人口普查中土著人口的社会人口构成,并根据2010年人口普查调查了获得基本卫生设施和电力方面的不平等现象。提出了一种方法,将有土著居民的家庭分为“同质”家庭、与土著居民“混合”在“户主”类别、与非土著居民混合在“户主”类别。地区和环境差异与家庭类型和位置的差异重叠,城市地区的条件好于农村地区,东南部和南部地区的条件好于农村地区。总的来说,北方是最难进入的地区。观察到区域差异和城乡之间的差异,东南部和南部的城市条件较好。这些不平等反映了支离破碎的公共政策、经济压力和非领土化等因素。新技术的发展和批判性辩论对于理解和解决该国的种族不平等现象以及促进适合土著人民的公共政策至关重要。
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引用次数: 0
Adaptation of prenatal care offered to indigenous women: maternal characteristics and health services. 适应向土著妇女提供的产前护理:产妇特征和保健服务。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-01 Epub Date: 2024-05-23 DOI: 10.1590/1413-812320242912.08722024
Gislaine Recaldes de Abreu, Renata Pálopi Picoli, James Robert Welch, Carlos E A Coimbra Junior

This study aimed to analyze the adaptation of prenatal care offered to Indigenous women and its association with maternal characteristics and health services. This is a cross-sectional study, conducted with 461 Indigenous women who gave birth and/or received immediate postpartum care in the municipalities of Mato Grosso do Sul, between 2021 and 2022. An indicator of minimum prenatal adequacy was developed, which was classified as adequate when the woman started prenatal care in the 1st trimester of pregnancy, had ≥7 consultations, and had routine exams recorded. Logistic regression models were used to estimate the adjusted odds ratios and factors associated with prenatal adequacy. It was found that 67.2% began prenatal care in the 1st trimester, 51.8% had ≥7 consultations, and 40.6% had exam results recorded. About 1 in 4 Indigenous women achieved the proposed adequacy; the associated maternal characteristics were ethnicity, region of residence, and place of residence. Prenatal care revealed health inequities, with low adequacy rates in prenatal care and worse rates among women living in villages and settlements in the southern region of the state.

本研究旨在分析向土著妇女提供的产前护理的适应性及其与产妇特征和保健服务的关系。这是一项横断面研究,对2021年至2022年期间在南马托格罗索州各市分娩和/或接受产后立即护理的461名土著妇女进行了调查。制定了最低产前适足性指标,当妇女在妊娠前三个月开始产前护理,咨询次数≥7次,并有常规检查记录时,该指标被归类为适足。采用Logistic回归模型估计校正后的优势比和与产前适足性相关的因素。67.2%的孕妇在妊娠早期就开始了产前护理,51.8%的孕妇咨询次数≥7次,40.6%的孕妇有检查结果记录。大约四分之一的土著妇女达到了所提议的适足性;相关的母亲特征是种族、居住地区和居住地。产前护理显示出保健方面的不平等,产前护理的充分率低,居住在该州南部地区村庄和定居点的妇女的充分率更低。
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引用次数: 0
Access to oral health services in the Xukuru do Ororubá Indigenous Territory (2017-2018): analysis of performance indicators. 在奥罗鲁布苏库鲁<e:1>土著领土获得口腔保健服务(2017-2018年):绩效指标分析。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-01 Epub Date: 2024-04-26 DOI: 10.1590/1413-812320242912.07092024
Lucas Fernando Rodrigues Dos Santos, André Luiz Sá de Oliveira, Fabíola Bof de Andrade, Herika de Arruda Mauricio, Thatiana Regina Fávaro, Rafael da Silveira Moreira

This ecological study conducted with secondary data extracted from the Indigenous Health Care Information System (SIASI) analyzed the access to oral health services provided to Xukuru do Ororubá Indigenous peoples from 2017 to 2018. The units of analysis were the Indigenous villages. The services delivered by the oral health teams working in the context were analyzed, verifying access and performance indicators and their parameters. The socioeconomic and demographic conditions, the provision of services, and the spatial components of the territory were characterized. The correlation coefficients between indicators were estimated. The results showed a growing coverage of first dental appointments, the mean number of procedures per capita, the percentage of tooth extractions, the coverage of supervised tooth brushing, and a decrease in the rate of completed treatments. There were better access opportunities for the Xukuru do Ororubá Indigenous people in the period analyzed. However, there is a persistent need to strengthen the continuity of services to complete treatments. The study points to the need for indicators suitable for the context of Indigenous health and the potential of the SIASI for oral health surveillance.

这项生态研究使用了从土著卫生保健信息系统(SIASI)中提取的二手数据,分析了2017年至2018年Xukuru do ororub土著人民获得口腔卫生服务的情况。分析的单位是土著村庄。分析了在这种情况下工作的口腔保健小组提供的服务,核实了获取和绩效指标及其参数。分析了该地区的社会经济和人口状况、服务提供情况以及空间构成。估计了各指标间的相关系数。结果显示,首次牙科预约的覆盖率、人均平均手术次数、拔牙的百分比、监督刷牙的覆盖率和完成治疗的比率有所下降。在分析期间,Xukuru do ororub土著人民获得了更好的机会。但是,始终需要加强服务的连续性,以完成治疗。该研究指出,需要制定适合土著居民健康状况的指标,以及口腔健康监测系统在口腔健康监测方面的潜力。
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引用次数: 0
Scenarios of Indigenous Health and challenges for Public Policy. 土著居民健康状况和公共政策的挑战。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-01 DOI: 10.1590/1413-812320242912.11482024
Ricardo Ventura Santos, Luiza Garnelo, Felipe Guimarães Tavares, Inara do Nascimento Tavares, Ana Lucia de Moura Pontes
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引用次数: 0
Challenges for implementing culturally competent obstetric services in an Indigenous context in Mexico. 在墨西哥土著环境中实施具有文化能力的产科服务的挑战。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-01 Epub Date: 2024-05-02 DOI: 10.1590/1413-812320242912.07332024
Clara Juárez-Ramírez

Obstetric healthcare for Indigenous women remains a severe problem in low-income countries with great cultural diversity and a colonial past. The work of health professionals to prevent complications leading to maternal deaths is paramount, yet in these contexts, they face significant challenges in implementing culturally competent services. This paper aims to present findings from an ethnographic study that attempted to document the experience of health professionals providing obstetric services in order to show the complex sociocultural contexts in which they perform their work.

土著妇女的产科保健仍然是具有巨大文化多样性和殖民历史的低收入国家的一个严重问题。保健专业人员预防导致产妇死亡的并发症的工作至关重要,但在这些情况下,他们在提供符合文化要求的服务方面面临重大挑战。本文旨在介绍一项民族志研究的结果,该研究试图记录提供产科服务的卫生专业人员的经验,以显示他们在其中开展工作的复杂社会文化背景。
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引用次数: 0
Analysis of cases of intimate partner violence against indigenous women reported in the macroregion of Dourados-MS, Brazil. 巴西杜拉多斯- ms大区域报告的针对土著妇女的亲密伴侣暴力案件分析
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-01 Epub Date: 2024-06-19 DOI: 10.1590/1413-812320242912.10312024
Glênio Alves de Freitas, Gláucia Elisete Barbosa Marcon, James Robert Welch, Cosme Marcelo Furtado Passos da Silva

The present study aimed to analyze notifications of intimate partner violence (IPV) against indigenous women in the macro-region of Dourados-MS, Brazil, from 2009 to 2020. This is a cross-sectional study with secondary data from registered reports in the Notifiable Diseases Information System (SINAN) of indigenous women who suffered violence. Descriptive statistics of the variables and Poisson regression were performed to determine the prevalence ratio (PR). IPV represented 56.6% of reports. The most reported types of violence were physical violence (93.3%) and psychological violence (27%). In the adjusted analysis, IPV was associated with women with partners (PR 1.32, 95%CI 1.19; 1.46), and women in situations of repeated violence (PR 1.15, 95%CI 1.05; 1.25) and at home as the place of occurrence (PR 1.13, 95%CI 1.01; 1.29). The majority of reports of violence against indigenous women registered in the Dourados health macro-region were perpetrated by an intimate partner. Knowledge of the profile of violence that arrives at health services, combined with associated factors, should enable the implementation of strategies aimed at reducing the number of cases.

本研究旨在分析2009年至2020年巴西杜拉多斯- ms宏观地区土著妇女遭受亲密伴侣暴力(IPV)的通报情况。这是一项横断面研究,其辅助数据来自法定疾病信息系统(SINAN)中关于遭受暴力的土著妇女的登记报告。对变量进行描述性统计和泊松回归,确定患病率(PR)。IPV占报告的56.6%。报告的暴力类型最多的是身体暴力(93.3%)和心理暴力(27%)。在校正分析中,IPV与有伴侣的女性相关(PR 1.32, 95%CI 1.19;1.46),反复遭受暴力的妇女(相对危险度1.15,95%可信区间1.05;1.25),家中为发病地点(PR 1.13, 95%CI 1.01;1.29)。在杜拉多斯卫生大区登记的针对土著妇女的暴力行为报告中,大多数是由亲密伴侣实施的。了解保健服务机构所掌握的暴力情况,结合相关因素,应有助于实施旨在减少案件数量的战略。
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引用次数: 0
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