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 Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Centro de Referência Professor Hélio Fraga. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio 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 Saúde Pública Sérgio 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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Brasil, Índios Sul-Americanos, Saúde de Populações Indígenas, Mato Grosso, Região Amazônica, Epidemiologia, Região Centro-Oeste, FUNASA, DSEI Xavante, Política Nacional de Atenção à Saúde dos Povos Indígenas, Xavante, Tuberculose, Etnografia, Serviços de Saúde, Vacina BCG, Registros Médicos, Teste Tuberculínico, Antropologia Médica, Avaliação Clínica, Notificação de Doenças, Distrito Sanitário Especial Indígena
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Brasil, Saúde de Populações Indígenas, Índios Sul-Americanos, Ecossistema Amazônico, Epidemiologia, Sistemas Locais de Saúde, Antropologia Médica, Serviços de Saúde do Indígena, Vacina BCG, Teste Tuberculínico
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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
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