Diarrhea and health inequity among Indigenous children in Brazil: results from the First National Survey of Indigenous People's Health and Nutrition

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open access
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2015
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BMC
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Universidade Federal de Rondônia. Departamento de Medicina. Porto Velho, RO, Brasil
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Rio de Janeiro, RJ, Brasil.
Universidade Federal de Pelotas. Pelotas, RS, Brasil
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Museu Nacional. Departamento de Antropologia. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Rio de Janeiro, RJ, Brasil.
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Abstract
BACKGROUND: Globally, diarrhea is the second leading cause of death among children under five. In Brazil, mortality due to diarrhea underwent a significant reduction in recent decades principally due to expansion of the primary healthcare network, use of oral rehydration therapy, reduced child undernutrition, and improved access to safe drinking water. The First National Survey of Indigenous People's Health and Nutrition in Brazil, conducted in 2008-2009, was the first survey based on a nationwide representative sample to study the prevalence of diarrhea and associated factors among Indigenous children in the country. METHODS: The survey assessed the health and nutritional status of Indigenous children < 5 years of age based on a representative sample of major Brazilian geopolitical regions. A stratified probabilistic sampling was carried out for Indigenous villages. Within villages, children < 5 years of age in sampled households were included in the study. Interviews were based on a seven day recall period. Prevalence rates of acute diarrhea were calculated for independent variables and hierarchical multivariable analyses were conducted to assess associations. RESULTS: Information on diarrhea was obtained for 5,828 children (95.1% of the total sample). The overall prevalence of diarrhea was 23.5%. Regional differences were observed, with the highest rate being in the North (38.1%). Higher risk of diarrhea was observed among younger children and those who had less maternal schooling, lower household socioeconomic status, undernutrition (weight-for-age deficit), presence of another child with diarrhea in the household, and occurrence of upper respiratory infection. CONCLUSIONS: According to results of the First National Survey of Indigenous People's Health and Nutrition, almost a quarter of Indigenous children throughout the country had diarrhea during the previous week. This prevalence is substantially higher than that documented in 2006 for Brazilian children < 5 years generally (9.4%). Due to its exceedingly multicausal nature, the set of associated variables that remained associated with child diarrhea in the final multivariable model provide an excellent reflection of the diverse social and health inequities faced by Indigenous peoples in contemporary Brazil.
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Brasil, Índios Sul-Americanos, Região Norte, Saúde de Populações Indígenas, Região Nordeste, Epidemiologia, Região Centro-Oeste, Região Sul, Região Sudeste, Saúde da Criança, Diarréia, Determinantes Sociais da Saúde, Estudos Epidemiológicos, Desigualdades em Saúde, Doenças Infecciosas e Parasitárias, Inquéritos Nutricionais, Inquéritos Epidemiológicos, Inquérito Nacional de Saúde e Nutrição, Alimentação e Nutrição
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Brasil, Saúde de Populações Indígenas, Índios Sul-Americanos, Epidemiologia, Saúde da Criança, Diarreia, Disparidades nos Níveis de Saúde, Inquéritos Epidemiológicos, Inquéritos Nutricionais, Doenças Infecciosas, Doenças Parasitárias, Alimentos, Dieta e Nutrição
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ESCOBAR, Ana Lúcia et al. Diarrhea and health inequity among Indigenous children in Brazil: results from the first national survey of indigenous people's health and nutrition. BMC Public Health, v. 15, n. 191, p. 01-11, 2015.
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1471-2458
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10.1186/s12889-015-1534-7
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