Ana Lúcia Escobar

RESUMO A tuberculose permanece como prioridade de saúde pública no Brasil e atinge níveis preocupantes em certos segmentos sociais, como é o caso dos povos indígenas. O objetivo deste artigo é proceder a uma análise epidemiológica do banco de dados do Programa Municipal de Controle da Tuberculose em Cacoal, Rondônia, buscando-se caracterizar o perfil da doença no grupo indígena Suruí. Foi conduzida análise descritiva dos casos notificados entre 1975 e 2002. Os resultados evidenciam indicadores epidemiológicos alarmantes se comparados a de outros segmentos populacionais indígenas e não-indígenas. O coeficiente de incidência médio de tuberculose verificado nos Suruí no decênio 1991-2002 foi de 2518,9 por 100.000 habitantes. Foi observado que 45% dos casos foram em crianças < 15 anos e 63,3% eram do sexo masculino. Somente 43,2% dos casos notificados tiveram confirmação baciloscópica. Não há registro de realização de testes com PPD, cultura ou exame histopatológico no período. Chama-se a atenção para a necessidade de implementação de medidas de prevenção e controle voltados especificamente para a realidade dos povos indígenas. Palavras-chaves: Epidemiologia. Tuberculose. Índios sul-americanos. Serviços de saúde. ABSTRACT Tuberculosis persists as a serious public health problem in Brazil. Prevalence rates are alarming in certain social groups, including indigenous peoples. This article presents an epidemiological analysis of records for the Suruí Indians available at the Tuberculosis Control Program in the Municipality of Cacoal, Rondônia. The study includes a descriptive statistical analysis of cases reported from 1975 to 2002. There is evidence that the Suruí have an increased risk of acquiring and dying from tuberculosis as compared to other indigenous groups in Rondônia as well as non-Indians. The average incidence coefficient for tuberculosis in the Suruí was 2518.9 per 100,000 inhabitants in the period 1991-2002. It was observed that 45% of the cases were diagnosed in children < 15 years old. Over half of the cases (63.3%) were reported in men. Only 43.2% of the cases were confirmed by sputum microscopy. The use of PPD skin tests, histopathological exams or bacteriological culture were not reported throughout the period. Attention is called to the need for prevention and control measures specifically tailored to the reality of indigenous peoples.

O B J E C T I V E : To investigate the characteristics of tuber-culin skin test reactivity in the Pakaanóva Indians, in Amazonia, Brazil, after revaccination of all study participants with bacille Calmette-Guérin (BCG). M E T H O D S : The investigation was designed as a post-BCG vaccination purified protein derivative (PPD) survey. Data included PPD readings, age, sex, nutritional status, place of residence, previous tuberculosis, physical examinations and BCG status. Bivariate and multivari-ate logistic regression analyses were conducted. R E S U L T S : About 90% (n 505) of the total population participated. One third (32.1%) of the subjects presented induration 10 mm at 72 h. Induration sizes showed weak linear correlation with age; differences between sexes were not observed. Skin reaction was not associated with nutritional status. Individuals with a history of tuberculosis were six times more likely to test positive. History of tuberculosis, age, and previous BCG vaccination were significantly associated with PPD reactivity in the multivariate analyses. C O N C L U S I O N : The Pakaanóva showed a high proportion (58.4%) of non-reactors, even with a recent BCG booster. Sex differences in PPD reactivity were either not present or could not be demonstrated. The association between age and PPD reactivity resembles that observed in other Amazonian populations. The authors discuss the potential of PPD testing as a screening tool to enhance tuberculosis detection, especially in indigenous populations in Amazonia with limited access to health services.

Based on data from a nationally representative sample of indigenous villages in Brazilian indigenous reserves, the study sought to estimate the prevalence of pneumonia and evaluate associated factors among indigenous children under 5 years of age. Sociodemographic, clinical and reported data on child respiratory health from the First National Survey of Indigenous People&#39;s Health and Nutrition in Brazil were collected for 6128 children. Prevalence of pneumonia was calculated for independent variables and hierarchical multivariate analyses were performed to assess associations. The overall prevalence proportions of cough, nasal congestion, pneumonia, and pneumonia with fever were 44.4%, 31.0%, 2.63%, and 1.28%, respectively. In the multivariate model, pneumonia was more frequent among children living in the South/Southeast and North regions of Brazil. Children living in larger households or houses with wood or thatch roofing, as well those with low birthweight or stunting, present...

Based on data from a nationally representative sample of indigenous villages in Brazilian indigenous reserves, the study sought to estimate the prevalence of pneumonia and evaluate associated factors among indigenous children under 5 years of age. Sociodemographic, clinical and reported data on child respiratory health from the First National Survey of Indigenous People&#39;s Health and Nutrition in Brazil were collected for 6128 children. Prevalence of pneumonia was calculated for independent variables and hierarchical multivariate analyses were performed to assess associations. The overall prevalence proportions of cough, nasal congestion, pneumonia, and pneumonia with fever were 44.4%, 31.0%, 2.63%, and 1.28%, respectively. In the multivariate model, pneumonia was more frequent among children living in the South/Southeast and North regions of Brazil. Children living in larger households or houses with wood or thatch roofing, as well those with low birthweight or stunting, present...