Ciencia & saude coletiva最新文献

This study aimed to estimate the COVID-19 lethality in the Mexican Indigenous population from 2020 to 2022, considering clinical characteristics and social conditions. Data were retrieved from the Epidemiological Surveillance System of Respiratory Diseases, identifying the COVID-19-positive cases among the Indigenous population. Lethality was evaluated per clinical conditions and vulnerability due to social deprivation. The number of COVID-19-positive cases in the Indigenous population represented 0.7% of the total number of cases. The case fatality rate in the Indigenous population was 9.8% against 4.6% in the non-Indigenous population. Lethality was higher in men. However, the association with diabetes, hypertension, chronic kidney disease, obesity, and smoking was lower in the Indigenous population than in the non-Indigenous population. A greater vulnerability to social conditions was identified among the Indigenous population than the non-Indigenous population, mainly regarding income, education, and access to health services.

Considered an important public health problem among Indigenous peoples in Brazil, obesity is a risk factor for Noncommunicable Diseases (NCDs) and conditions. The present study aimed to describe the occurrence of excess weight, obesity, and associated factors in Xavante Indigenous adults, through a nutritional survey carried out in the population ≥ 15 years of age living in the Pimentel Barbosa and Wedezé Indigenous Lands, Mato Grosso, Central Brazil, during the period of June to August 2011. Eight of the 10 villages in the territory were investigated. Anthropometric, bioimpedance and socioeconomic data were collected. This study counted on 495 participants, corresponding to 94.1% of the target population. The prevalence of overweight and obesity was 65.9% (male: 63.2%; female: 68.6%) and 19.8% (male: 21.3%; female: 18.2%), respectively. In the multiple regression model, the prevalence of excess weight was higher among women, in higher age groups and education levels, in individuals living in group 2 of the villages, and in households with low consumption of farmed foods. An increase in the age group aged 20 to 49 years and in individuals living in households with a low consumption of food from hunting, fishing, and gathering presented the highest prevalence of obesity.

This case study analyzed arrangements and strategies of the network actors in the Special Indigenous Sanitary District (DSEI) Pernambuco's territory to guarantee the right to health of Indigenous populations during the COVID-19 pandemic. This work was carried out through document analysis, workshops, and field research. The Contingency Plan for COVID-19 in Indigenous Peoples of DSEI Pernambuco included surveillance actions, laboratory and pharmaceutical assistance, communication, and management. With the modeling of this document, it was noticed that actions aimed at local specificities were not integrated: in its initial design, at the national level, the voice of Indigenous leaders was not heard when formulating this plan. By contrast, the actions of these leaders and their mobilization to mitigate the effects of the pandemic on the Indigenous population stands out. Contextual factors were cited as facilitators and obstacles to the plan's implementation; the local sociotechnical network mapping also made it possible to identify strategic actors and actants in the face of the COVID-19 pandemic and verify their performance or ineffectiveness. The findings of this study reflect recurrent problems in the organization of the Indigenous health system.

The present study aimed to assess the anthropometric nutrition status and physical growth of Terena Indigenous children living in an urban zone of the city of Campo Grande, Mato Grosso do Sul, Brazil, in their first year of life. Children who were born between June 2017 and July 2018 (n = 42) participated in the study. In total, 4.8% of the children presented a low height for age (H/A) in the 12th month of life. According to body mass index (BMI) for age, overweight affected 15.0% of the individuals belonging to the female sex at the age of 12 months, and obesity was observed in 4.8% of the children belonging to both sexes at this same age. Terena Indigenous children's length curve failed to reach the median value recorded for the reference population. Weight and body mass index curves for age, mainly among individuals belonging to the female sex, were often above the reference median value. The Terena growth curves recorded an average linear growth of lower than expected and a weight gain of higher than the reference median. This profile is compatible with the persistence of unfavorable conditions for children's growth and nutrition, as well as with an accelerated process of food and nutritional transition, where the racial dimension of health inequities cannot be disregarded.

This study analyzes the implementation of the Indigenous Health Policy, focusing on the care practices of health teams of the Indigenous Health Care Subsystem in the Upper Solimões River in the Amazon region. Using ethnography as a methodological resource, the dynamics among participants, discourses, and power in the implementation of the policy are investigated, revealing a complex interconnection between practices and other contextual realities. Three phenomena emerge as critical influences on care practices: the medical-care model, the sanitation model, and the culture of performance. The medical-care and sanitation models are perpetuated. The culture of performance introduces a control paradigm based on quantitative indicators and pre-defined goals, affecting professional identity, social interactions, and the effectiveness of actions. On the margins of the institution, other daily practices are induced by temporal needs, subjective feelings, and local networks of power, thus challenging social structures and conventions. The Indigenous Health Policy was reformulated by practices influenced by old policies and was remodeled by techniques induced by bureaucracy, distancing itself from its ideological agenda.

Part of this text resulted in a lecture presented at the opening of the 20th National Science and Technology Week of the Oswaldo Cruz Foundation in October 2023. It is the reflection of an Indigenous historian on her professional trajectory, considering the racism in force in the scientific community and the paths that the Indigenous knowledge rivers have traveled to demarcate writing as a field for securing the rights guaranteed in the 1988 Federal Constitution, constituting a space of resistance for the continuity of the Brazilian Indigenous peoples' plural existences.

Estimating average blood pressure levels and prevalence of arterial hypertension (AH) and associated factors is essential to monitoring health and planning actions to combat noncommunicable diseases (NCDs) in Indigenous peoples in Brazil. This is a cross-sectional study that investigated average blood pressure levels and prevalence of arterial hypertension in 4,680 Indigenous women (aged 18-49 years), using data from the 1st National Survey of Health and Nutrition of Indigenous Peoples (2008-2009) and associated factors, such as through gamma regression and multilevel logistics. The prevalence of hypertension was 10.7%, varying across macro-regions: North, Northeast, Midwest, and South/Southeast. Women who lived in villages without domestic waste collection and in households without stable income were more likely to have AH. Increasing BMI and age were positively associated with the chances of developing high blood pressure. In the model for DBP, unlike education, the variables stable household income, BMI, and age were positively associated. In the model for SBP, there was a negative association with education, in the medium and high strata of the household goods index and in households with no stable income, and a positive association with the housing indicator, BMI and age.

The COVID-19 pandemic has unevenly affected regions, countries, and ethnic-racial segments. Socioenvironmental factors were associated with worse disease evolution, with a greater likelihood of mortality in vulnerable people. This study aimed to investigate the association between the proportion of vulnerable populations (Black, brown, and Indigenous people) and mortality from COVID-19 in Brazil from March 2020 to February 2021. Mortality rate ratios and respective 95% Confidence Intervals (95%CI) were estimated using negative binomial regression models. Statistically significant associations were found between the proportion of these populations and mortality rates, emphasizing Blacks in the first four-month period, mixed race in the second four-month period, and Indigenous people in the third four-month period, in which an increase of 54%, 16% and 27% in mortality rates was observed, respectively, for every 10% increase in the proportion of these populations. We highlight the existence of ethnic-racial inequalities in COVID-19 mortality in Brazil and that efforts must be made to mitigate health inequalities, an expression of the perpetuated structural racism and social exclusion of historically vulnerable groups.

This article aims to characterize Indigenous people aged 18-23 of the Xukuru do Ororubá ethnic group, Pernambuco state, Brazil, regarding the use of dental services, self-perceived oral health, oral hygiene practices and caries experience, and socioeconomic and demographic aspects. This population-based cross-sectional study is nested in a cohort study that started in 2010 and was conducted in the Indigenous territory in 2018. Oral examinations and questionnaires were conducted with 131 Indigenous people. Data were collected using Epi Info software and the SPSS 20.0 statistical program was used for descriptive statistics. R software was adopted to compare the caries experience results obtained with the National Oral Health Survey (SB Brasil 2010). The caries experience verified by the DMFT Index had a mean of 7.4, with the mean Index components corresponding to 22.8 for healthy teeth, 2.4 for decayed teeth, 0.2 for filled/carious teeth, 3.5 for filled teeth, and 1.4 for missing teeth. The oral health condition of Indigenous people is characterized by significant inequality when compared to the results of epidemiological surveys conducted in the country involving other population groups.

This work presents concepts and practices linked to mental health in the Tupinambá Indigenous community of Serra do Padeiro in southern Bahia, Brazil. This qualitative cartographic research mapped existing processes and relationships in the Tupinambá territory. Data production techniques were participant observation, semi-structured interviews, field diary, and bibliographic studies. Shared responsibility characterizes how Indigenous medicine care is organized in the territory. The factors that produce psychosocial distress, care practices, and conflict coping are understood from the interactions between Indigenous and non-Indigenous ways of care. The inseparability between psychic and social is combined with territorial dimensions, reinforcing the link between mental health and daily community life. The struggle for territory enables the reconstruction of a subjective ethos that refuses servitude, moving from previous conditions of precariousness and subalternity, with expulsion from the territory to other more autonomous and collective subjectivation processes. The example of Serra do Padeiro highlights that the struggle offers the most significant health.