Tuberculosis among the Xavante Indians of the Brazilian Amazon: an epidemiological and ethnographic assessment
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open access
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Article
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2010
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Taylor & Francis
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Fundação Oswaldo Cruz. Escola Nacional de SaĂșde PĂșblica SĂ©rgio Arouca. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Escola Nacional de SaĂșde PĂșblica SĂ©rgio Arouca. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Escola Nacional de SaĂșde PĂșblica SĂ©rgio Arouca. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Centro de ReferĂȘncia Professor HĂ©lio Fraga. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Escola Nacional de SaĂșde PĂșblica SĂ©rgio Arouca. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Museu Nacional. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Escola Nacional de SaĂșde PĂșblica SĂ©rgio Arouca. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Escola Nacional de SaĂșde PĂșblica SĂ©rgio Arouca. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Escola Nacional de SaĂșde PĂșblica SĂ©rgio Arouca. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Centro de ReferĂȘncia Professor HĂ©lio Fraga. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Escola Nacional de SaĂșde PĂșblica SĂ©rgio Arouca. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Museu Nacional. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Escola Nacional de SaĂșde PĂșblica SĂ©rgio Arouca. Rio de Janeiro, RJ, Brasil
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Abstract
Abstract
_Despite broad availability of a national tuberculosis (TB) control program that has proved effective in Brazil, TB remains a major cause of morbidity and mortality among indigenous peoples. AIM_ We report the results of an interdisciplinary investigation of TB epidemiology, healthcare services, and ethnomedicine among the Xavante Indians of Central Brazil. SUBJECTS AND METHODS_ Fieldwork components included clinical assessment of TB (479 subjects, 89.3% of the population = 1 year of age), analysis of medical health records, and ethnographic research. RESULTS_ We found TB to constitute a major health risk, with moderately high annual risk of infection (0.94%), moderate prevalence of infection, high percentage of X-ray images suggestive of TB (14.2% in subjects _ or = 10 years of age), and a relatively low percentage of individuals with reactive TB skin tests (16.6% of reactions _ or = 10 mm) despite high BCG vaccine coverage. We also found a high rate of TB patients showing no evidence of prior infection. Ethnographic interviews show that Xavante and biomedical health perspectives are simultaneously divergent in their etiologies but pragmatically compatible. CONCLUSION_ Ineffective diagnosis procedures compromise the efficacy of existing TB prevention efforts and threaten to undermine otherwise favorable institutional and cultural conditions_
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Keywords in Portuguese
Brasil, Ăndios Sul-Americanos, SaĂșde de PopulaçÔes IndĂgenas, Mato Grosso, RegiĂŁo AmazĂŽnica, Epidemiologia, RegiĂŁo Centro-Oeste, FUNASA, DSEI Xavante, PolĂtica Nacional de Atenção Ă SaĂșde dos Povos IndĂgenas, Xavante, Tuberculose, Etnografia, Serviços de SaĂșde, Vacina BCG, Registros MĂ©dicos, Teste TuberculĂnico, Antropologia MĂ©dica, Avaliação ClĂnica, Notificação de Doenças, Distrito SanitĂĄrio Especial IndĂgena
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Brasil, SaĂșde de PopulaçÔes IndĂgenas, Ăndios Sul-Americanos, Ecossistema AmazĂŽnico, Epidemiologia, Sistemas Locais de SaĂșde, Antropologia MĂ©dica, Serviços de SaĂșde do IndĂgena, Vacina BCG, Teste TuberculĂnico
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BASTA, Paulo Cesar et al. Tuberculosis among the Xavante Indians of the Brazilian Amazon: an epidemiological and ethnographic assessment. Annals of Human Biology, v. 37, n. 5, p. 643-657, 2010.
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1464-5033
DOI
10.3109/03014460903524451