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Abstract In Brazil, current information about breastfeeding indicators among indigenous living in the urban areas is lacking. This article describes the duration of exclusive breastfeeding and its associations with mother and child characteristics in a cohort of Terena infants. The study enrolled infants born between June 2017 to July 2018 (n = 42) and living in villages of the urban area of Campo Grande, Mato Grosso do Sul State, Brazil. Information was collected in four time-points. Variables on maternal sociodemographics and on maternal and child health characteristics were collected, respectively, during the antenatal and the first-month interviews. Variables on breastfeeding practices and bottle use were collected during the first-, six- and 12-month interviews. Associations were examined using Wilcoxon, Kruskal-Wallis, Pearson’s chi-square, and Fisher’s exact tests. The prevalence of exclusive breastfeeding duration to the ages of three and six months were, respectively, 50% and 11.9%. Compared to infants never introduced to bottles during the first three months of life, those bottle-fed had lower median duration of exclusive breastfeeding (15 versus 150 days) and lower prevalence of exclusive breastfeeding duration to the age of three months (22.7% versus 80%). Most Terena infants fell short of meeting the international recommended duration of exclusive breastfeeding until six months of age and suggested the negative impact of bottle use in the duration of exclusive breastfeeding.

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Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Birth weight is an important predictor of perinatal, infant, and preschool-age children morbimortality. However, information about indigenous children’s birth weight is still scarce. This study aimed to analyze the birth weight of indigenous children based on data from the First National Survey of Indigenous People’s Health and Nutrition, Brazil (2008-2009). This is the first study to address indigenous children’s birth weight based on a nationwide representative sample. Mean birth weights and the respective standard deviations were calculated according to geopolitical region, sex, type of birth, and birthplace. The chi-square test was used to analyze differences in proportions, and Kruskal-Wallis and Mann-Whitney U tests in means, considering sample design and data normality. We found no records on birth weight in the researched documents for 26.7% of the 6,128 sampled children. The mean birth weight for the 3,994 children included in the analyses was 3,201g (standard deviation - SD ± 18.6g), regardless of sex, type of birth, and birthplace. The prevalence of low birth weight was 7.6% (n = 302) and was significantly higher among girls. Boys presented significantly higher mean birth weight than girls, regardless of the geopolitical region. Low birth weight was slightly less frequent among indigenous children when compared to Brazilian children in general. Our study indicates the need to improve prenatal care and the quality of consultation records for indigenous women as a strategy to promote safe pregnancy and childbirth.

The testaments and codicil transcribed and analyzed in this section belong to the painter Pedro Tello, native of Quito and neighbor of Popayán. These documents were written in the mid-18th century and the early 19th century. The particular life of Pedro Tello made it possible to find him in these two localities and confirm that he is one of the many artists of the Latin American colonial period who have remained in oblivion, both in Ecuadorian and Colombian historiography. Despite of having been “exposed [abandoned] to the doors” of Juan Antonio Tello, Pedro had a good life, thanks to his craft as a painter, and he owned workshops and apprentices in both cities. He acquired enough assets to support his wife María Ventura de los Cobos, to buy a house in Popayán and to leave a legacy to his mother, Tomasa Rosales. Our interest is to show the variety of data obtained by crossing information from the payanese testaments and the Quito deeds. By doing so, Pedro’s life no longer appears divided by the current national boundaries and, as we find more documents that reinforce our knowledge of his itinerary, business, charity and knowledge, we acquire a complete picture of his career. This information is part of the documentary tracking that we carried out on artists and craft workers during the 17th and 18th centuries in the southwest of the New Kingdom of Granada and the Royal Audience of Quito.

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Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This research is about Native homosexual activism in a comparative perspective between Brazil and the United States. The idea is to work as starting points with the queer theory, the coloniality of gender and two-spirit critiques in order to understand homosexuality as a Native critique of colonial apparatus (bureaucratic and missionary) normalizer, heterosexual, male, white and European. Several writings of two-spirit in the United States reflect a critique of queer studies in the sense that queer theorists share a Western, white and modern perspective. Thus, they could not fully understand the native sexualities as an attitude of opposition to the colonization process.

Objective: To estimate the prevalence of obesity and overweight and associated factors in indigenous people of the Jaguapiru village in Central Brazil. Methods: We conducted a population-based cross-sectional study between January 2009 and July 2011 in the adult native population of the Jaguapiru village, Central Brazil. Sociodemographic and lifestyle data were obtained; anthropometric measures, arterial blood pressure, and blood glucose were measured. The independent variables were tested by Poisson regression, and the interactions between them were analyzed. Results: 1,608 indigenous people (982 females, mean age 37.7 ± 15.1 years) were included. The prevalence of obesity was 23.2% (95% CI 20.9-25.1%). Obesity was more prevalent among 40- to 49-year-old and overweight among 50- to 59-year-old persons. Obesity was positively associated with female sex, higher income, and hypertension. Among indigenous people, interactions were found with hypertension and sedentary lifestyle - hypertension in males and sedentary lifestyle in females. Conclusions: The prevalence of obesity and overweight in indigenous people of the Jaguapiru village is high. Males as well as hypertensive and higher family income individuals have higher rates. Sedentary lifestyle and hypertension leverage the rates of obesity. Prevention and adequate public health policies can be critical for the control of excess weight and its comorbidities among Brazilian indigenous people.

The article analyzes the singular encounter between the Sateré-Mawé cosmography and the social policies of the Brazilian State, in particular the Conditional Cash Transfer Program. The Sateré-Mawé have as main modalities of relations with nature, one considered not demanding, that operates in a system of simple operations, activated mainly in the context of the acquisition / extraction of environmental resources. This modality coexists with a demanding regime, characterized by the obligations and responsibilities of the adult person, capable to have command of mastering the productive processes that guarantee their capacity for agency and existence. The Conditional Cash Transfer programs create their own political ecology, helping to eroding Sateré-Mawé's ontological autonomy and bolstering unconditional consumption, which fails to instantiate the necessary means to replicate productive processes. The devaluation of subsistence practices beyond the physical reproduction of persons are also strategies of constructing communal life, stimulates a concept of personhood based on the simple receipt of goods eroding symbolic, value-based and auto-constructive dimensions of the Sateré-Mawé person. [ABSTRACT FROM AUTHOR]

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A Política Nacional de Saúde Bucal redefiniu em 2011 seu modelo de atenção para os povos indígenas, preconizando o subsídio da epidemiologia e o acompanhamento do impacto das ações por meio de indicadores adequados. O objetivo deste estudo foi analisar a evolução desses indicadores, propostos pelo Ministério da Saúde, no Parque Indígena do Xingu, Brasil, no período de 2004-2013. Trata-se de pesquisa de abordagem quantitativa, com o uso de dados secundários do Distrito Sanitário Especial Indígena Xingu e do Projeto Xingu, da Universidade Federal de São Paulo. Observou-se cobertura de primeira consulta odontológica programática maior que 60% em todos os anos analisados, exceto em 2009 e 2010, cujas coberturas foram de 44,7% e 53,4%, respectivamente. O indicador de tratamento odontológico básico concluído apresentou aumento significativo, de 44,9% para 79,9%, entre 2006 e 2008. A proporção de exodontias no conjunto dos procedimentos diminuiu de 24,3% em 2004 para 3,8% em 2011. A cobertura da média da ação coletiva de escovação dental supervisionada obteve a maior variabilidade (1,2 a 23,3%) no período analisado. O acesso à saúde bucal mostrou boa cobertura e o indicador de tratamento concluído apresentou percentual mais elevado em comparação com outros povos indígenas no mesmo período. O melhor desempenho do indicador de exodontias pode decorrer de mudança no enfoque assistencial possibilitado por parcerias com universidades, ainda que os indicadores de escovação supervisionada indiquem ser necessário priorizar ações preventivas. Mudanças na gestão da saúde indígena, com fragilização ou ausência de parcerias, podem ter influenciado negativamente os indicadores do programa.

Com a intenção de ampliar o conhecimento sobre a situação epidemiológica da tuberculose (TB) entre populações vulneráveis no Brasil, nosso objetivo foi analisar características sociodemográficas e indicadores operacionais referentes ao controle da TB, comparando indígenas e não indígenas em Rondônia. Realizou-se estudo epidemiológico descritivo e retrospectivo dos casos novos de TB notificados entre 01/01/1997 e 31/12/2006. Foram excluídos os registros duplicados e aqueles para os quais o desfecho foi mudança de diagnóstico e transferência. Os casos de TB foram classificados em duas categorias: indígenas e não indígenas, e foi realizada análise, segundo sexo, faixa etária, procedência (urbana/rural), UF de residência, forma clínica, exames diagnósticos, indicadores de acompanhamento e situação de encerramento. Ao todo foram identificadas 4.832 notificações, com 322 casos (6,7%) em indígenas. Houve predomínio no sexo masculino (razões: 1,7 em não indígenas e 1,3 em indígenas). A maioria das notificações em indígenas (82,6%) foi da zona rural e houve elevada concentração (36,0%) em menores de 15 anos. A análise dos exames realizados demonstrou predomínio de baciloscopias positivas em não indígenas (56,1%) e baciloscopias negativas e não realizadas entre indígenas (31,7% e 35,4%, respectivamente, P valor = 0,0001). Houve diferença no acompanhamento em relação à baciloscopia do 2º mês (6,1% de positividade, P valor = 0,0001) e no exame de pelo menos um contato (69,6%, P valor = 0,017) para não indígenas. Por outro lado, o tratamento supervisionado esteve mais associado aos casos indígenas (23,6%, P valor = 0,0001). Destaca-se o predomínio de cura em ambos os grupos, com maior concentração em indígenas (90,4%, P valor = 0,0001), e maior proporção de abandono em não indígenas (14,7%, P valor = 0,0001). A abordagem empregada mostrou-se útil para elucidar desigualdades e superou as usuais análises realizadas nos serviços de vigilância que visam delinear a situação epidemiológica da TB baseadas, apenas, em taxas ou valores absolutos.With the intention of improve knowledge on the epidemiological situation of tuberculosis (TB) among vulnerable populations in Brazil, our objective was to analyze sociodemographic characteristics and operational indicators related to TB control, comparing indigenous and non-indigenous people, in Rondônia. We conducted a retrospective and descriptive epidemiological study of new TB cases reported between 1997, January 1st and 2006, December 31st. We excluded duplicate records and those for whom the results of treatment was change in diagnosis and transfer. TB cases were classified into two categories: indigenous and non-indigenous people and analysis was performed according to sex, age, origin (urban /rural), State of residence, clinical form, diagnostic tests, monitoring indicators and results of treatment. Altogether 4832 cases were reported, with 322 cases (6.7%) in indigenous people. There was a male predominance (ratios: 1.7 to 1.3 in non-indigenous and indigenous people). The majority of cases for indigenous people (82.6%) was in rural area and there was high concentration of cases (36.0%) in children < 15 years. The analysis of diagnostic tests showed a predominance of smear positive in non-indigenous (56.1%) and smear negative and smear not performed in indigenous people (31.7% and 35.4% respectively, P value=0.0001). There was difference in the monitoring in relation to smear of second month (6.1% positivity, P value = 0.0001) and exam at least one contact (69.6%, P value = 0.017) for non-indigenous. On the other hand, DOTS was more associated with indigenous people cases (23.6%, P value = 0.0001). Stands out the predominance of cure in both groups, with bigger concentration in indigenous people (90.4%, P value = 0.0001) and higher rate of noncompliance in non-indigenous (14.7%, P value = 0.0001). The approach showed useful for elucidate inequalities and has exceeded the usual analysis carried out surveillance on services that aim to delineate the epidemiological situation based only on rates or absolute values.

The objective was to analyze the relationship between socioeconomic status and age at menarche among indigenous and non-indigenous girls in the Araucanía Region of Chile, controlling for nutritional status and mother's age at menarche. A total of 8,624 randomly selected girls from 168 schools were screened, resulting in the selection of 207 indigenous and 200 non-indigenous girls who had recently experienced menarche. Age at menarche was 149.6±10.7 months in the indigenous group and 146.6±10.8 months in the non-indigenous group. Among the non-indigenous, the analysis showed no significant association between age at menarche and socioeconomic status. In the indigenous group, age at menarche among girls with low socioeconomic status was 5.4 months later than among those with higher socioeconomic status. There were no differences in nutritional status according to socioeconomic level. Obesity was associated with earlier menarche. Menarche occurred earlier than in previous generations. An inverse relationship between socioeconomic status and age at menarche was seen in the indigenous group only; low socioeconomic status was associated with delayed menarche, regardless of nutritional status or mother's age at menarche.El objetivo fue analizar la relación entre nivel socioeconómico y edad de menarquia en adolescentes indígenas y no indígenas de la Región de la Araucanía, Chile, controlando el efecto del estado nutricional, y la edad de menarquia de las madres. Se estudiaron 8.624 niñas de 168 escuelas elegidas aleatoriamente, seleccionando 207 indígenas y 200 no indígenas que habían tenido recientemente la menarquia. La edad de menarquia ocurrió a los 149,6±10,7 meses en indígenas y a los 146,6±10,8 meses en no indígenas. En el grupo no indígena, hubo una relación significativa entre edad de menarquia y nivel socioeconómico. En el grupo indígena, edad de menarquia del nivel socioeconómico bajo fue de 5,4 meses más tarde que el nivel socioeconómico más alto. No se observaron diferencias de estado nutricional por nivel socioeconómico. La obesidad adelantó la menarquia y la edad de menarquia ocurrió antes que la de sus madres. Existe una relación inversa entre nivel socioeconómico y edad de menarquia sólo en el grupo indígena; en los niveles socioeconómicos más bajos la edad de menarquia se retrasa independiente del estado nutricional y de la edad de menarquia de la madre.

ABSTRACT OBJECTIVE: To describe the characteristics and the raw suicide mortality rates (RSMR) during the period 2000-2007 in the municipality with the largest proportion of self-reported indigenous people in Brazil, São Gabriel da Cachoeira (SGC), State of Amazonas. METHOD: A retrospective descriptive study was carried out using data from the Information Department of the Brazilian Unified Health System (DATASUS). We considered suicide the cause of death coded in the records as voluntary self-Inflicted injuries according to the International Classification of Diseases and Related Health Problems, 10th revision. RESULTS: Forty-four suicide cases were registered in this period. The average RSMR was 16.8 per 100,000 inhabitants (male, 26.6; female, 6.3). The highest rates were observed in the age groups 15-24 years and 25-34 years, with RSMR of 43.1 and 30.2 per 100,000 inhabitants, respectively. Most suicides occurred among indigenous people (97.7%), males (81.8%), and unmarried people (70.5%). In most cases, deaths occurred at home (86.4%), during weekends (59.1%) and mainly by hanging (97.7%). CONCLUSION: Suicide is a significant health and social problem in SGC. The suicide profile observed in this municipality was, as a whole, more similar to that observed in certain indigenous communities than that found in most urban and non-indigenous environments, demonstrating the sociocultural specificity of these events in Brazil.OBJETIVOS: Descrever as características e as taxas brutas de mortalidade por suicídio (TBMS), no período de 2000-2007, no município brasileiro com a maior proporção de pessoas autodeclaradas indígenas, São Gabriel da Cachoeira (SGC), Estado do Amazonas, Brasil. MÉTODO: Estudo retrospectivo e descritivo, utilizando dados do Departamento de Informática do Sistema Único de Saúde (DATASUS). Foram considerados óbitos por suicídio os registros codificados como lesões autoprovocadas voluntariamente na Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde, 10ª revisão. RESULTADOS: Foram registrados 44 suicídios no período. A TBMS média foi 16,8 por 100.000 habitantes (masc., 26,6; fem., 6,3). As taxas mais elevadas foram observadas nas faixas etárias 15-24 e 25-34 anos, com TBMS 43,1 e 30,2 por 100.000 habitantes, respectivamente. A maioria dos suicídios ocorreu entre indígenas (97,7%), do sexo masculino (81,8%) e solteiros (70,5 %). Os óbitos ocorreram em sua maioria em casa (86,4%), no final de semana (59,1%) e principalmente por enforcamento (97,7%). CONCLUSÃO: O suicídio é um importante problema social e de saúde pública em SGC. O perfil dos suicídios observados neste município como um todo foi mais próximo daquele encontrado em certos contextos indígenas do que o encontrado em ambientes urbanos e não indígenas, demonstrando as especificidades socioculturais desses eventos no Brasil.

Este estudo analisou a distribuição espacial e temporal das incidências brutas e ajustadas de tuberculose (TB) no período 1997-2006, identificando áreas de maior risco para indígenas e não indígenas de Rondônia, Brasil. Foi realizado estudo ecológico, tendo como unidades de análise municípios e Terras Indígenas (TI), utilizando método bayesiano empírico local para ajuste das taxas. A incidência média bruta de TB para não indígenas foi 35,6/100.000 habitantes, enquanto para indígenas foi 415,0/100.000 habitantes. As TI Karipuna, Sete de Setembro, Igarapé Ribeirão e Karitiana apresentaram incidência > 600/100.000. Observou-se nos indígenas maior número de casos em < 15 anos e com baixa escolaridade, diferente do ocorrido nos não indígenas. Após ajuste, as taxas em algumas TI ultrapassaram 240/100.000, enquanto, nos municípios coincidentes com as TI, elas ficaram entre 61-120/100.000 habitantes. O método bayesiano diminuiu a heterogeneidade das taxas. Evidências apontam os indígenas como grupo mais vulnerável ao adoecimento e mostram áreas que requerem maior atenção para adequado controle da TB em Rondônia.This study analyzed the spatial and temporal distribution of crude and adjusted rates of incidence of tuberculosis (TB) between 1997 and 2006, identifying areas of greatest risk to the indigenous and non-indigenous population of Rondônia State, Brazil. An ecological study was conducted analyzing municipalities and Indian reserves, using the local empirical Bayesian method. The crude average rate of incidence of TB among the non-indigenous population was 35.6/100,000 inhabitants, while for the indigenous population it was 415.0/100,000. Rates greater than 600/100,000 were reported in the Karipuna, Sete de Setembro, Igarapé, Ribeirão and Karitiana reserves. We observed a greater number of cases in under 15 year-olds with little schooling in contrast to the situation in the non-indigenous population. After making adjustments, the rates in some Indian reserves exceeded 240/100,000 inhabitants, while in coinciding municipalities incidence was between the range of 61-120/100,000. The Bayesian method led to decreased overall heterogeneity in rates. Evidence suggests that the indigenous population is more vulnerable to contracting TB and highlighted areas that require further attention to ensure the adequate control of TB in Rondônia.

O objetivo do estudo foi o de analisar os aspectos demográficos e o padrão de mortalidade da população indígena aldeada do Estado do Mato Grosso do Sul, Brasil, comparativamente ao da população total do estado. Foram calculados indicadores de mortalidade a partir dos dados obtidos do Sistema de Informação de Atenção à Saúde Indígena e do consolidado mensal, assim como, do módulo demográfico e do Sistema de Informações sobre Mortalidade do SUS. Observaram-se, na população indígena, comparativamente à do estado, maior proporção de indivíduos menores de 15 anos e menor de idosos e taxas mais elevadas de mortalidade em idades precoces e por doenças infecciosas e parasitárias. Os homens indígenas apresentaram taxas significativamente maiores para as causas externas, doenças do aparelho respiratório e doenças infecciosas. Entre as mulheres, apenas as causas externas e doenças infecciosas se destacaram. A grande importância dos suicídios na juventude apresentou-se como aspecto relevante. As condições de saúde da população indígena são piores que a da população total.The present study aimed to assess mortality rates and related demographic factors among indigenous peoples in the State of Mato Grosso do Sul, Central-West Brazil, compared to the State's general population. Mortality rates were estimated based on data obtained from the Health Care Database for Indigenous Peoples and monthly patient care records as well as demographic data from the Brazilian Unified National Health System (SUS) and mortality data from the SUS Mortality Database. Compared to the overall population, among indigenous peoples there were proportionally more individuals under 15 years of age and fewer elderly, besides higher mortality rates at early ages and from infectious and parasitic diseases. Indigenous men showed significantly higher mortality rates from external causes and respiratory and infectious diseases, while among women the mortality rates from external causes and infectious diseases were higher. Suicide rates among young indigenous individuals were also particularly alarming. Indigenous people's health conditions are worse than those of the general population in Mato Grosso do Sul.

OBJETIVOS: investigar a prevalência e os fatores associados à ocorrência de anemia em mulheres indígenas Suruí com idade entre 15 e 49 anos. MÉTODOS: estudo transversal realizado a partir de levantamento censitário em 2005 na terra indígena Sete de Setembro, localizada em Rondônia, Brasil. A dosagem de hemoglobina (Hb) foi realizada pelo aparelho β-hemoglobinômetro portátil. Pontos de corte de anemia: Hb OBJECTIVES: to investigate the prevalence of and factors associated with the occurrence of anemia in indigenous Surui women aged between 15 and 49 years. METHODS: a cross-sectional study was carried out based on the 2005 census of Sete de Setembro indigenous territory in the Brazilian State of Rondônia. Hemoglobin measurement (Hb) was carried out using a portable β-hemoglobinometer. The cut-off points for anemia were Hb

The authors conducted a cross-sectional study of the local canine population in the Krenak indigenous community to detect parasites of the genus Leishmania and identify the circulating species and the proportion of asymptomatic dogs, while investigating associations between canine infection and the dogs' sex, age, and hair length. A seroepidemiological survey was performed, including 63 dogs. All the animals underwent clinical examination to verify the presence of characteristic signs, and serum samples were taken for serological tests (ELISA, IIF). Infected dogs culled by the health service were necropsied and the material was analyzed using molecular diagnostic techniques. The cross-sectional study detected a 46% prevalence rate, and the circulating species was Leishmania (L.) chagasi. The statistical analysis showed no association between infection and the independent variables. The study generated data on the epidemiological situation with canine infection in the area, which was previously unknown.Foi realizado um estudo seccional para detectar, na população canina, a presença de parasitos do gênero Leishmania e a espécie circulante, a proporção de cães assintomáticos, investigando concomitantemente a existência de associações entre a infecção canina e as variáveis: sexo, idade e tipo de pelo dos cães. Para o estudo seccional, foi realizado um inquérito censitário, que avaliou 63 cães. Todos passaram por uma avaliação clínica para verificar a presença de sintomas característicos da infecção; amostras de soro foram coletadas para os testes sorológicos (ELISA, RIFI). Os cães positivos retirados pelo serviço de saúde foram necropsiados, e o material, analisado pelas técnicas de diagnóstico molecular. O estudo seccional realizado detectou uma prevalência de 46%, sendo a espécie circulante a Leishmania (L.) chagasi. A análise estatística não detectou nenhuma associação entre infecção e as variáveis investigadas. Este estudo possibilitou a geração de dados sobre a situação epidemiológica da infecção canina na área, o que antes era desconhecido.

Analisam-se interações estabelecidas entre os Baniwa, grupo indígena do Alto Rio Negro, e equipes multidisciplinares de saúde que desenvolvem vacinação naquela região. Apoiando-se no enfoque da antropologia da doença, em estudos de etnologia rionegrina e na teoria das representações sociais, busca-se apreender as interpretações indígenas sobre ações de vacinação e sobre as doenças por elas evitadas. Os resultados mostram que as ideias biomédicas sobre vacina são reinterpretadas à luz da cosmologia baniwa. Conclui-se que a vitalidade do pensamento baniwa os impulsiona a interpretar as ações biomédicas conforme suas características culturais, mas o desencontro de perspectivas entre indígenas e profissionais de saúde tem implicações negativas no processo de vacinação.The article analyzes interactions between the Baniwa, an indigenous group from the Alto Rio Negro region, and the multi-disciplinary healthcare teams that conduct vaccination there. Approaching from the perspectives of the anthropology of disease, studies of Rio Negro ethnology, and the theory of social representations, the study endeavors to comprehend indigenous interpretations of vaccination and the diseases these seek to prevent. Results show that biomedical ideas about vaccines are re-interpreted through Baniwa cosmology. It is concluded that the vigor of Baniwa thought encourages these indigenes to interpret biomedical action in accord with cultural features and that the clash between Baniwa outlooks and those of healthcare providers has negative repercussions on the vaccination process.

INTRODUÇÃO: Entre os Suruí de Rondônia foram registradas incidências médias de TB > 2.500/100.000 habitantes, entre 1991-2002. Aproximadamente 50% desses casos foram notificados em < 15 anos. MÉTODOS: Trata-se de um estudo clínico-epidemiológico que teve como objetivo descrever as características clínico-radiológicas em crianças e adolescentes identificados como contatos de doentes de TB. Além disto, aplicar o sistema de pontuação para o diagnóstico de TB na infância e verificar se as condutas adotadas no nível local foram concordantes com as diretrizes nacionais. RESULTADOS: Foram analisados 52 Rx de 37 indígenas. Deste conjunto, 48,1% foram normais e 51,9% anormais. Alguns dos Rx apresentaram duas ou mais alterações, totalizando 36 eventos independentes. Observou-se infiltrados (38,9%), calcificações (38,9%), cavitações (11,1%) e atelectasias/derrame pleural (11,1%). Nas imagens anormais, 22,2% eram TB provavelmente ativa e 33,3% sequelas. A confrontação com as diretrizes constatou 52,6% de condutas discordantes. CONCLUSÕES: A presença da infecção tuberculosa latente (ITBL) e TB ativa, entre crianças e adolescentes, são indicadores de transmissão ativa e continuada do Mycobacterium tuberculosis. Os Rx mostrando alta frequência de infiltrados e calcificações é compatível com primo-infecção em idade precoce. Entretanto, essas alterações não são diferentes daquelas observadas entre outros grupos, não sugerindo comprometimento imunológico. As discordâncias apontadas indicam que o momento ideal para o tratamento da ITBL passou despercebido. Conclui-se que é fundamental a utilização do sistema de pontuação para o correto diagnóstico de TB na infância, assim como a realização de baciloscopia e cultura de escarro em adolescentes capazes de expectorar.INTRODUCTION: The average incidence coefficient of tuberculosis in Suruí Indians from Rondônia was 2.500/100.000 inhabitants in 1991-2002. About 50% of these cases were reported in children < 15 years-old. METHODS: This study aimed to describe the clinical and radiological characteristics of children and adolescents identified as TB case contacts. A score system for the diagnosis of childhood TB was used and the procedures adopted by local health services were in accordance with national guidelines. RESULTS: 52 chest X-rays of 37 indigenous subjects were analyzed; of these, 51.9% were abnormal. Some X-rays showed more than two lesions, making a total of 36 independent events. Infiltrates (38.9%), calcifications (38.9%), cavitations (11.1%) and atelectasis/pleural effusion (11.1%) were observed. Among the abnormal images, 22.2% were probably indicated active TB and 33.3% showed sequelae. Confrontation with the guidelines revealed 52.6% of divergent procedures. CONCLUSIONS: The presence of latent tuberculosis infection (LTBI) and active TB between children and adolescents are indicators of active and progressive transmission of Mycobacterium tuberculosis. The X-rays showed high frequencies of infiltrates and calcifications, which are compatible with primary infection in early childhood. However, these lesions are not different from those observed among other groups and do not suggest immune deficiencies. The divergences presented show that the best moment for the treatment of LTBI went unnoticed by local personnel. In conclusion, the use of a score system is fundamental for the correct diagnosis of TB in childhood, as is conducting bacilloscopy and sputum culture in adolescents able to expectorate.

Caracterizar o estado nutricional de 3.254 Kaingáng de escolas indígenas de 12 terras indígenas do Rio Grande do Sul, Brasil. Transversal de base escolar. Obtidas medidas de peso (P), estatura (E) e circunferência da cintura (CC) conforme Organização Mundial da Saúde - OMS (1995). Classificação do estado nutricional: crianças: índices E/I, P/I e P/E, de acordo com o National Center for Health Statistics (WHO, 1995) e E/I, P/I e índice de massa corporal/idade (IMC/I) de acordo com OMS (2006); adolescentes: IMC/I (OMS, 1995 e 2006) e E/I (OMS, 2006); adultos: IMC (OMS, 1995) e CC (OMS, 2003). Adolescentes representaram 56% dos avaliados, crianças 42,5%, adultos 1,4% e idosos 0,1%. Deficit estatural de 15,1% (OMS, 1995) e 15,5% (OMS, 2006) entre as crianças e de 19,9% entre adolescentes. Freqüências de excesso de peso foram: crianças: 11% (OMS, 1995) e 5,7% (OMS, 2006); adolescentes: 6,7%; adultos: 79,2%. Entre adultos, 45,3% estavam em risco aumentado para doenças metabólicas. Observada a transição nutricional no segmento, caracterizada por prevalências importantes de baixa estatura na infância e adolescência e sobrepeso proeminente em todas as faixas etárias.The study's objective was to characterize the nutritional status of 3,254 Kaingáng Indians in indigenous schools in Rio Grande do Sul State, Brazil. This was a school-based study. Weight (W), height (H), and waist circumference (WC) were measured according to World Health Organization guidelines (1995). Children's nutritional status classification included H/A, W/A, and W/H according to the National Center for Health Statistics (WHO, 1995) and H/A, W/A, and body mass index/age (BMI/A) according to WHO (2006). Adolescents were classified for BMI/A (WHO, 1995 and 2006) and H/A (WHO, 2006). Adults were classified for BMI (WHO, 1995) and WC (WHO, 2003). Adolescents represented 56% of the sample, children 42.5%, adults 1.4%, and elderly 0.1%. Prevalence rates for stunting were 15.1% (WHO, 1983) and 15.5% (WHO, 2006) in children and 19.9% in adolescents. Prevalence rates for overweight were 11% (WHO, 1983) and 5.7% (WHO, 2006) in children, 6.7% in adolescents, and 79.2% in adults. 45.3% of adults were at increased risk of metabolic diseases. A nutritional transition was observed in the group, characterized by significant prevalence of stunting in children and adolescents and prominent overweight in all age groups.

Este artigo analisa o consumo e as percepções de medicamentos entre índios Guaraní do litoral de Santa Catarina, Brasil. A pesquisa etnográfica envolveu observação participante, entrevistas abertas e semi-estruturadas e pesquisa domiciliar. Analisando seis meses (2008) de prescrições médicas, foram indicados 458 medicamentos em 236 consultas, sobressaindo-se as preparações para tosse e resfriado, os analgésicos e os anti-helmínticos, entre outros. Nas três pesquisas domiciliares, os analgésicos e as preparações para tosse e resfriado foram os mais encontrados em 2006 e 2007, e os antianêmicos em 2008. Os Guaraní utilizavam os serviços de atenção básica principalmente para gripe, tosse e diarréia, incluindo também em suas práticas a procura pelo pajé e a autoatenção com medicamentos e ervas, reconhecendo para os medicamentos sua eficácia e avaliando o tratamento de acordo com suas experiências e concepções do processo saúde-doença-atenção. O estudo indica a necessidade de diálogo entre profissionais e usuários, articulando os diferentes saberes em saúde.This article analyzes the use of medicines and related perceptions among Guaraní Indians on the coast of Santa Catarina State, Brazil. The ethnographic research included participant observation, open and semi-structured interviews, and household surveys. Analyzing six months of prescriptions from 2008, 458 medicines were prescribed in 236 medical consultations, featuring cough and cold preparations, analgesics, and anti-helminthics, among drugs. In the three household surveys, analgesics and cough and cold preparations were the most frequently found in 2006 and 2007, while drugs for anemia were the most common in 2008. The Guaraní mainly used the primary healthcare services for colds, coughs, and diarrhea, and their practices also included turning to the shaman and self-care with medicines and herbal remedies, recognizing the efficacy of medicines and evaluating the treatment according to their experiences and their conceptions of the health-disease-care process. The study indicates the need for dialogue between professionals and users, linking the various forms of health knowledge.

O objetivo do estudo foi avaliar níveis de experiência de cárie entre subgrupos Xavante que vivem em diferentes Terras Indígenas (T.I.) no Estado de Mato Grosso, Brasil, a fim de investigar a presença de desigualdades no interior de uma mesma etnia indígena. Os dados foram coletados através de um censo de saúde bucal realizados em 2004. Das sete T.I. Xavante existentes, foram investigadas quatro (Pimentel Barbosa, Sangradouro, Areões e Marechal Rondon), nas quais foram selecionadas a maior aldeia de cada. Foram adotados os critérios preconizados pela Organização Mundial da Saúde, e utilizado o índice CPOS. Para mensurar as diferenças entre as T.I. foi estimada a razão de prevalência (RP) por meio de análise de regressão de Poisson, efetuada na faixa etária entre 6 e 34 anos para cada sexo, incluindo a idade como covariável. Nesta faixa etária, as perdas variaram entre 26 a 30%. Pimentel Barbosa foi considerada como referência para comparações por apresentar menor prevalência de cárie em todas as faixas etárias analisadas. A maior disparidade foi notada entre as T.I. Pimentel Barbosa e Sangradouro, tanto em homens (RP 2,68- IC95% 2,41 a 2,97) como em mulheres (RP 2,03- IC95% 1,85 a 2,23). A RP do componente obturado em Areões e Marechal Rondon (diferença relativa a Pimentel Barbosa) é muito pequena em relação à carga de doença total nestas T.I., indicando menor presença de serviço odontológico restaurador. Conclui-se que a transição em saúde bucal não é homogênea entre os Xavante e que as diferenças podem estar associadas a particularidades do processo histórico de interação com a sociedade não-indígena. Determinantes locais e regionais, incluindo fatores demográficos, características econômicas e sócio-culturais específicas, acesso e utilização de serviços de saúde, podem ter determinado as desigualdades de ataque de cárie observadas entre os Xavante.The aim of the study was to investigate caries experience levels in the Xavante Indians, in the state of Mato Grosso, Brazil, with a focus on between-group differences. Oral health data were collected in 2004, following WHO guidelines in four of the seven Xavante reserves (Pimentel Barbosa, Sangradouro, Areões and Marechal Rondon). Data were collected in the largest village in each of the reserves, using the DMFS index. Statistical analyses included sex-specific Poisson regressions to compare DMFS values among Xavante reserves. Prevalence ratios (PR) were used to measure the differences in caries experiences in the 6-to-34-year age group, whose losses varied between 26% and 30%. Xavante from the Pimentel Barbosa community were selected as reference group as they showed a lower prevalence of caries in all age groups. The major difference in DMFS was observed between Pimentel Barbosa and Sangradouro, both in males (PR 2.68, 95%CI 2.41-2.97) and in females (PR 2.03, 95%CI 1.85-2.23). The PRs of the filled component in Areões and Marechal Rondon (relative difference to Pimentel Barbosa) were lower, when compared to the total burden of disease observed in those reserves, indicating very low presence of restorative services. It was concluded that the oral health transition among Xavante has not been homogeneous and the differences found in caries experiences can be associated with the particularities of the interaction process between Indians and non-Indians. Local and regional determinants, including factors related to demography, specific economic and socio-cultural characteristics, health care access and type of oral health services received might have influenced the between-group differences in dental caries observed in the Xavante Indians.

O objetivo do presente estudo foi analisar a saúde das mulheres Kaingáng da Terra Indígena Faxinal, Paraná, Brasil, quanto aos fatores de risco para o câncer de mama. O estudo, de caráter descritivo-exploratório, foi realizado com 95,4% da população feminina com vinte anos ou mais. O aleitamento materno por mais de 1 ano foi relatado por 92,3% das mulheres; 41,4% tinham mais de cinco filhos; a idade média da menarca foi 13,4 anos; 61,5% nunca tinham ouvido falar do câncer de mama; o auto-exame da mama era realizado por apenas 2,9% das mulheres; o médico não realizava o exame clínico da mama, segundo 81,7% delas, e 99% nunca fizeram mamografia. Não foi relatado caso de câncer de mama ou extramamário. Destacaram-se a presença dos fatores de proteção para a carcinogênese e a ausência de alguns fatores de risco, como o uso de terapia de reposição hormonal por mais de cinco anos e etilismo, na maioria das mulheres Kaingáng.This study analyzes the health of Kaingáng women in the Faxinal indigenous territory in Paraná State, Brazil, with regard to risk factors for breast cancer. A descriptive and exploratory investigation was undertaken that included 95.4% of females 20 years or over. Data showed that 92.3% of Kaingáng women reported breastfeeding for more than one year; 41.4% had more than 5 children; mean age at menarche was 13.4 years; 61.5% had never heard of breast cancer; breast self-examination was only performed by 2.9%; 81.7% reported no clinical breast examination by a physician; 99% had never had a mammogram. No cases of breast or non-breast cancer were reported. The study highlights protective factors against carcinogenesis and the absence of key risk factors like hormone replacement therapy for more than five years and alcohol consumption in most Kaingáng women.

Os Hupd'äh são um povo de língua Maku, habitante da região do Alto Rio Negro, Amazonas, Brasil. Lideranças indígenas, antropólogos, missionários e profissionais de saúde afirmam que eles estariam vivendo em condições de saúde precárias, com alta mortalidade geral e infantil. A partir de dados provenientes do Distrito Especial Indígena do Rio Negro - DSEI-RN, da Funasa/MS, para o período 2000-2003, foi realizado um estudo descritivo para avaliar o perfil demográfico e conhecer melhor essa população, contribuindo para a implementação de políticas públicas que lhe favoreçam e para os debates em antropologia, demografia e saúde indígena. A população de 1.487 indivíduos, em 2003, cresceu 8,4% ao ano no período estudado. Sua composição por idade e sexo indica concentração de jovens (44,9% com menos de 15 anos), além da predominância de população do sexo masculino. A taxa bruta de natalidade (TBN) média do período foi de 33,4 nascimentos por mil habitantes, a de fecundidade total (TFT) correspondeu a 3,4 filhos por mulher, a de mortalidade (TBM) foi de 10 óbitos por mil habitantes e a de mortalidade infantil (TMI) chegou a 116,3 óbitos por mil nascimentos. O aperfeiçoamento da coleta de informações, o elevado crescimento vegetativo e a intensa mobilidade espacial dos Hupd'äh poderiam explicar o alto ritmo de crescimento verificado entre 2000 e 2003.Los Hupd'äh son un pueblo de lengua Maku, habitante de la región del Alto Río Negro, Amazonas, Brasil. Liderazgos indígenas, antropólogos, misionarios y profesionales de la salud, afirman que estarían viviendo en condiciones de salud precarias, con alta mortalidad general e infantil. A partir de datos provenientes del Distrito Especial Indígena del Río Negro - DSEI-RN, de la Funasa/MS, para el período 2000-2003, fue realizado un estudio descriptivo para evaluar el perfil demográfico y conocer mejor esta población, contribuyendo con la implementación de políticas públicas que la favorezcan y para los debates en antropología, demografía y salud indígena. La población de 1.487 individuos, en 2003, creció un 8,4% al año en el período estudiado. Su composición por edad y sexo indica concentración de jóvenes (44,9% con menos de 15 años), además de la predominancia de población del sexo masculino. La tasa bruta de natalidad (TBN) media del período fue de 33,4 nacimientos por mil habitantes, la de fecundidad total (TFT) correspondió a 3,4 hijos por mujer, la de mortalidad (TBM) fue de 10 muertes por mil habitantes y la de mortalidad infantil (TMI) llegó a 116,3 muertes por mil nacimientos. El perfeccionamiento de la recolección de informaciones, el elevado crecimiento vegetativo y la intensa movilidad espacial de los Hupd'äh podrían explicar el alto ritmo de crecimiento verificado entre 2000 y 2003.The Hupd'äh are a people of the Maku language who live in the Upper Rio Negro Region in Amazonas, Brazil. Indigenous leaders, anthropologists, missionaries and health professionals all say that this population lives under very precarious conditions of health, with high overall and child mortality rates. On the basis of data derived from the Special Indigenous District of Rio Negro (DSEI-RN, of Funasa/MS), for the period of 2000-2003, a descriptive study was conducted to evaluate the demographic and general profiles of the group The study also had the objective of contributing to the implementation of public policies for them, and for debates in the areas of anthropology, demography and indigenous health. The population of 1,487 individuals in 2003 grew 8.4% per year during the period studied. Composition by age and sex indicates a concentration of young people (44.9% under the age of 15), and a greater percentage of males. The average gross fertility rate (TBN) for the period was 33.4 births per 1000 inhabitants, and total fertility (TFT) was 3.4 children per woman. Mortality rate (TBM) was 10 deaths per 1000 inhabitants and child mortality rate (TMI) was high, 116.3 deaths per 1000 births. More refined processes of collecting information, the high vegetative growth and the intense spatial mobility of the Hupd'äh may explain the high growth rate seen between 2000 and 2003.

OBJETIVOS: Descrever e analisar comparativamente os dados antropométricos de crianças indígenas Suruí, Xavánte e Wari' menores de 60 meses, a partir dos conjuntos de curvas de crescimento NCHS/1977 e WHO/2005. MÉTODOS: A antropometria seguiu técnica padronizada e os dados foram convertidos em escores z utilizando-se os programas Epi-Info (Versão 3.4) e WHO-Anthro (Versão Beta). Os índices estatura/idade (E/I), peso/idade (P/I) e peso/estatura (P/E) foram os descritores do estado nutricional em todas as crianças menores que 60 meses e também o índice de massa corporal (IMC) nas de 24-59 meses. RESULTADOS: As prevalências de E/I < -2 escores z foram: crianças Suruí, 31,4 (NCHS/1977) e 38,6% (WHO/2005); Xavánte, 30,9 e 42,3%; Wari', 61,7 e 68,3%. As prevalências de P/I < -2 escores z foram: crianças Suruí, 12,4 (NCHS/1977) e 8,5% (WHO/2005); Xavánte, 16,5 e 11,6%; Wari', 51,7 e 45,0%. As prevalências de P/E < -2 escores z para as crianças Suruí foram nulas (NCHS/1977 e WHO/2005); para as Xavánte, 1,7 e 3,3%; e para as Wari', 1,7% e nula. As prevalências de P/E > 2 escores z para as crianças Suruí foram 3,9 (NCHS/1977) e 3,9% (WHO/2005); Xavánte, nula e 0,8%; Wari', nulas para ambas as curvas. Nas crianças Suruí de 24 a 59 meses o percentual com escore z > 2 para o IMC foi de 5,4% (WHO/2005); Xavánte, 9,5%; Wari', 0%. CONCLUSÕES: Há diferenças importantes nos resultados da avaliação nutricional, a depender do conjunto de curvas utilizadas, ainda que o emprego de ambas revele elevadas prevalências de desnutrição. Sugere-se que, inclusive para fins de comparabilidade, estudos com populações indígenas apresentem seus resultados utilizando os dois conjuntos de curvas de crescimento.OBJECTIVES: To perform a comparative analysis of anthropometric data from Suruí, Xavánte and Wari' indigenous children under 60 months of age using the NCHS/1977 and the WHO/2005 growth curves. METHODS: Anthropometric measurements followed standard procedures and the data obtained were converted into z scores using the Epi-Info (Version 3.4) and WHO-Anthro (Version Beta) softwares. The indices height/age (H/A), weight/age (W/A) and weight/height (W/H) were descriptors of nutritional status for all children under 60 months of age, as well as the body mass index (BMI) for children 24-59 months old. RESULTS: The frequencies of Suruí children < -2 z scores for H/A were 31.4 (NCHS/1977) and 38.6% (WHO/2005); Xavánte 30.9 and 42.3%; Wari' 61.7 and 68.3%. The frequencies of Suruí children < -2 z scores for W/A were 12.4 (NCHS/1977) and 8.5% (WHO/2005); Xavánte 16.5 and 11.6%; Wari' 51.7 and 45.0%. None of the Suruí children were < -2 z scores for W/H (NCHS/1977 and WHO/2005); the frequencies of Xavánte children were 1.7 and 3.3% and Wari' 1.7 and 0.0%. The frequencies of Suruí children > 2 z scores for W/H were 3.9 (NCHS/1977) and 3.9% (WHO/2005); Xavánte 0.0 and 0.8%; Wari' 0.0 and 0.0%. The frequency of Suruí children aged 24-59 months > 2 z scores for BMI was 5.4% (WHO/2005); Xavánte 9.5%; and Wari' 0.0%. CONCLUSIONS: Our findings revealed important differences in the results from nutritional assessment, according to the set of growth curves used; however, the use of both growth curves revealed a high prevalence of malnutrition. Therefore, future studies with indigenous populations should present their results using two sets of growth curves to allow consistent comparison.

Este estudo objetivou avaliar o estado nutricional de crianças indígenas e verificar os fatores associados à ocorrência de agravos nutricionais. Foram avaliadas 141 crianças Kaingáng de 0 a 60 meses de idade da Terra Indígena de Mangueirinha, Paraná, Brasil, por meio das medidas de peso e altura ou comprimento. Realizaram-se entrevistas com a aplicação de um questionário sobre condições materno-infantis e sócioeconômicas. Segundo os parâmetros da Organização Mundial da Saúde (2006), 24,8% das crianças apresentavam déficit de altura para idade (AI), 9,2% baixo peso para idade (PI), 2,1% baixo peso para altura (PA) e 2,1% baixo peso segundo o índice de massa corporal para idade (IMCI). De acordo com o NCHS (1977), 19,9% das crianças apresentaram baixa AI, 9,2% baixo PI e 1,4% baixo PA. O sobrepeso chegou a 6,4%, segundo o IMCI. O baixo peso ao nascer e os materiais utilizados na construção das paredes das casas estiveram estatisticamente associados com déficits antropométricos. Este estudo mostra que as crianças Kaingáng estão inseridas em um contexto marcado por precárias condições de vida, que estão associadas com indicadores desfavoráveis do estado nutricional.The goal of this study was to evaluate the nutritional status of indigenous children and to investigate factors associated with nutritional deficits. Weight and height measurements were obtained for 141 Kaingáng children from 0 to 5 years of age living on the Mangueirinha Indigenous Reserve in Paraná State, Brazil. Data on maternal and infant conditions and socioeconomic characteristics were also gathered through face-to-face interviews. Based on World Health Organization criteria (2006), 24.8% of the children presented low height-for-age (HA), 9.2% low weight-for-age (WA), 2.1% low weight-for-height (WH), and 2.1% low weight according to body mass index for age (BMIA). Based on NCHS criteria (1977), 19.9% of the children presented low HA, 9.2% low WA, and 1.4% low WH. 6.4% were overweight according to BMIA. Low birth weight and non-masonry housing construction were associated statistically with nutritional deficits. The Kaingáng children are subject to poor living conditions, associated with deficits in their nutritional profile.

Este estudo descreve o perfil demográfico dos índios Boróro de Mato Grosso, Brasil, no período de 1993 a 1996. O levantamento incluiu cadastros anuais e registros de eventos vitais, coletados a partir das atividades rotineiras do serviço de saúde da Fundação Nacional do Índio, da população de três aldeias (Garças, Meruri e Morada dos Boróro). A taxa média de crescimento foi de 2,4% ao ano. Observou-se que 44% da população tinham menos de 15 anos, com idade mediana de 16 anos. Verificaram-se taxas brutas de natalidade de 30,9 por mil e de mortalidade de 7,3 por mil. A taxa de mortalidade infantil para o período foi de 58,8 óbitos por mil nascidos vivos, e de fecundidade total de 4,3 filhos por mulher. As mulheres se casam mais cedo do que os homens e há um número expressivo de adultos, tanto homens (26,7%) quanto mulheres (13,3%) fora de uniões conjugais. Um aspecto que chama atenção é a relativamente baixa fecundidade encontrada se comparada a de outros grupos indígenas. Destaca-se a importância da coleta e análise sistemáticas de dados demográficos para os povos indígenas.This paper analyzes the demographic profile of the Boróro Indians from Mato Grosso State, Brazil, from 1993 to 1996. Data came from annual collection and registration of vital statistics conducted by the health service in three villages (Garças, Meruri, and Morada dos Boróro). The average annual population growth rate was 2.4%. Nearly half (44%) of the population was younger than 15 years (median 16 years). The crude birth rate was 30.9 per 1,000 and the crude death rate 7.3 per 1,000 inhabitants. The infant mortality rate was high (58.8 per thousand live births), probably resulting from precarious health conditions in the villages. The results showed that women married younger than men and that there were numerous unmarried adult men (26.7%) and women (13.3%), as compared to data from other indigenous groups. The total fertility rate of Boróro women was 4.3, quite low compared to other indigenous communities in Brazil. The study emphasizes the importance of systematically collecting and analyzing demographic data on indigenous populations.

Este estudo teve por objetivo descrever a situação de saúde bucal em índios Guaraní do Estado do Rio de Janeiro, Brasil. Um inquérito epidemiológico em saúde bucal, utilizando critérios da Organização Mundial da Saúde foi realizado em 508 sujeitos (90,7% da população). Aos 5 anos, 38,5% das crianças estavam livres de cárie e aos 12 o CPOD foi igual a 1,7. Observou-se que 54,2% dos indivíduos entre 35-44 anos e 12% entre 65-74 apresentavam 20 ou mais dentes. O número de dentes para 35-44 e 65-74 anos foi de 18,5 e 8,5. Enquanto o ceod não diferiu entre sexos, o CPOD e a perda dentária foram maiores em mulheres. Aproximadamente 60% da população não demonstraram problemas periodontais, enquanto 20,9% e 11,3% apresentaram sangramento gengival e cálculo como condições periodontais mais graves. Sangramento e cálculo foram mais comuns em homens, e sextantes excluídos em mulheres. Ações de promoção de saúde bucal são necessárias para esse grupo étnico e devem contemplar especificidades para diferentes grupos etários e de gênero.The aim of the present study was to describe the oral health conditions of Guaraní Indians in the State of Rio de Janeiro, Brazil. A cross-sectional oral health survey was conducted in 508 subjects (90.7% of the Guaraní population) using World Health Organization criteria. At 5 years of age, 38.5% of children were caries-free. DMF-T was 1.7 at 12 years. 54.2% of subjects in the 35-44-year group and 12% in the 65-74-year group had at least 20 teeth. Numbers of teeth for the 35-44 and 65-74 age groups were 18.5 and 8.5, respectively. While caries index did not differ by gender for deciduous teeth, DMF-T and tooth loss was higher in women. Nearly 60% of the population showed no periodontal illness. Gingival bleeding and calculus were the most severe periodontal conditions. Gingival bleeding and calculus were more common in men and excluded sextants more common in women. Oral health promotion strategies are needed for this ethnic group and should consider the epidemiological profile according to age and gender.

As populações indígenas aldeadas no Brasil apresentam alta taxa de fecundidade total (TFT), sendo que em alguns casos é observado o crescimento destas taxas ao longo do tempo. Já os dados do Instituto Brasileiro de Geografia e Estatística (IBGE) revelam um declínio da TFT da população autodeclarada indígena, independente da situação de domicílio (urbano, rural e rural específico). Este trabalho utiliza dados do Censo Demográfico 2000 para descrever e comparar a estrutura e o nível da fecundidade de período e coorte das mulheres autodeclaradas indígenas residentes em Minas Gerais, Brasil. Foram calculadas as taxas específicas de fecundidade (TEF), a TFT de período para o ano 2000 e a TFT de coorte para mulheres com cinqüenta anos e mais de idade. Os resultados mostram que as mulheres autodeclaradas indígenas residentes em Minas Gerais experimentaram um passado de alta fecundidade, independente da situação de domicílio. Concluiu-se que o uso do Censo Demográfico 2000 é uma importante fonte de dados para os estudos sobre populações indígenas no Brasil, tanto pelo seu alto grau de cobertura quanto pela riqueza das informações coletadas.Indigenous populations living in villages in Brazil have presented high total fertility rates (TFR) that have increased over time in some cases. Meanwhile, data from the Brazilian Institute of Geography and Statistics (IBGE) or National Census Bureau show a decline in the TFR for the total self-declared indigenous population (combining urban, rural, and specific rural residence). The current study uses data from the 2000 Population Census to describe and compare the structure and level of period fertility for the cohort of self-declared indigenous women living in the State of Minas Gerais. We calculated age-specific fertility rates (ASFR), the period TFR for 2000, and the cohort TFR for women 50 years and older. According to the findings, self-declared indigenous women living in Minas Gerais experienced high fertility in the past, regardless of their place of residence. In conclusion, the 2000 Population Census is an important data source for studies on indigenous populations in Brazil, based on the high coverage and wealth of information.

A fin de conocer la prevalencia de la infección por el virus de hepatitis B (VHB) en la comunidad indígena Japreira, Venezuela, y determinar las pautas de su adquisición en función de la edad y sexo, se seleccionaron 149 individuos de un total de 300. Se detectó por métodos serológicos la presencia de anticuerpos totales del VHB (anti-HBc total), y en las positivas se investigó la presencia del antígeno de superficie (HBsAg) y del antígeno "e" del VHB (HBeAg). La prevalencia de anti-HBc total fue de 72,9% en el sexo femenino y 81,1% en el masculino, la prevalencia de HBsAg fue elevada (61,1%) en el sexo masculino, sólo cuatro de los portadores de HBsAg fueron positivos para HBeAg. Los resultados obtenidos indican un grado elevado de endemia para esta infección y que su diseminación comienza a temprana edad. El factor involucrado en la adquisición y diseminación del virus seria la vía sexual. Hacinamiento, contacto intercorpóreo con fluidos biológicos, prácticas sociales, y características de la cepa viral circulante podrían estar involucradas en la alta cronicidad observada en la comunidad indígena Japreira.The aim of this study was to determine the prevalence of hepatitis B virus (HBV) infection in the Japreira indigenous community, Venezuela, and its relationship to age and gender. An intentional, non-probabilistic sample of 149 individuals was selected from a total of 300. All samples were studied for the presence of total HBV antibodies (total anti-HBc), and the positive samples were tested for HBV surface and "e" antigens (HBsAg, HBeAg). Overall prevalence rates of total anti-HBc were 72.9% in females and 81.1% in males. The highest prevalence of HBsAg was observed in males 26-35 years of age. Only four of the 44 HBsAg carriers were positive for HBeAg. The results showed a high endemic HBV infection rate and indicated that its spread begins at early ages. Sexual transmission may be the main route for spread of the virus. Crowding, close contact with bodily fluids, specific social practices, and features of the circulating viral strain among members of this community could be involved in the high chronicity observed in the Japreira indigenous community.

O povo Baniwa, grupo Aruak que vive no Noroeste amazônico, possui rica tradição mítica que influencia a expressão das dimensões políticas, éticas e práticas da vida social e orienta conhecimentos ancestrais que garantem a sobrevivência do grupo em condições ambientais adversas. O artigo analisa mitos e ritos estruturados em torno das fontes alimentares pesqueiras, em íntima interação com as explicações cosmológicas sobre a origem dos deuses, dos cursos d'água e dos micro-ecossistemas que favorecem a reprodução da fauna aquática. A mitologia Baniwa remete os processos reprodutivos dos peixes a um conjunto de relações sociais travadas entre sociedades humanas e não-humanas. Predação e comensalidade, noções subjacentes aos ritos alimentares, são concebidas como parte de um conjunto de práticas que visam à produção e manutenção das alianças de parentesco, à redução da periculosidade do alimento/presa e à manutenção do equilíbrio no balanço cósmico que garante a vida.The Baniwa people, a member of the Aruak group which lives in the northwestern Amazon, has a rich mythic tradition that influences how the political, ethical, and practical dimensions of their social life are expressed and that guides the ancestral knowledge that guarantees the group's survival under adverse environmental conditions. The article analyzes myths and rites built around fish as a food source; these have an intimate relationship with cosmological explanations of the origin of the gods, water bodies, and the micro-ecosystems that foster the reproduction of aquatic fauna. Baniwa mythology draws an association between the reproductive processes of fish and a set of social relations involving human and non-human societies. Predation and edibility - notions underlying food rites - are viewed as part of a set of practices meant to produce and maintain kinship alliances, ease the food/prey peril, and maintain the cosmic balance that sustains life.

A despeito da relevância do tema, as condições de alimentação e nutrição das populações indígenas no Brasil permanecem largamente desconhecidas. O presente estudo examina o caso de uma comunidade Wari', povo indígena localizado em Rondônia, no sudoeste amazônico. Foram realizados dois inquéritos antropométricos de modo a investigar a situação nutricional da população e analisar variações sazonais. Nos inquéritos, seis meses aparte, foram examinados 279 e 266 indivíduos com idades entre zero e 87 anos. As prevalências de baixa estatura (61,7%) e peso (51,7%) entre as crianças menores de cinco anos estão entre as mais elevadas já registradas na literatura sobre populações indígenas no Brasil. Sobrepeso e obesidade não são expressivos na população, seja qual for a faixa etária considerada. Os perfis antropométricos indicam condições mais desfavoráveis durante os meses de chuva, quando as prevalências de desnutrição em crianças aumentam e adultos de ambos os sexos apresentam menores médias de peso corporal. Aponta-se para a necessidade de se considerar a sazonalidade na definição de rotinas de vigilância nutricional e na discussão dos perfis de nutrição de povos indígenas.Despite the importance of nutritional status and eating practices among Brazilian indigenous populations, the subject has received little research attention. This study examines the Wari' community in Rondônia State, in the southwest Amazon. Two anthropometric surveys, six months apart, were carried out to characterize the group's nutritional status and investigate possible seasonal variations (n = 279 and 266; age range, 0-87 years). Prevalence rates of low height for age (61.7%) and weight for age (51.7%) in Wari' under-5 children were among the highest reported in the literature on indigenous populations in Brazil. Overweight and obesity were not common in the population, regardless of age. According to the anthropometric data, nutritional conditions are generally worse during the rainy season, when undernutrition increases in children, and both male and female adults lose weight. Seasonality is an important factor when defining nutritional surveillance protocols and discussing the nutritional status of indigenous peoples.

O objetivo deste trabalho foi descrever o perfil metabólico e antropométrico de índios Aruák (Mehináku, Waurá e Yawalapití) que habitam o Alto Xingu, Brasil Central. Em julho de 2000 e outubro de 2002, 201 indivíduos de ambos os sexos e com idade > 20 anos foram submetidos a exames físicos (antropometria e pressão arterial) e de laboratório (glicemia de jejum, lípides séricos e ácido úrico). Índios do sexo masculino, quando comparados aos do sexo feminino, apresentaram valores médios menores de dobras cutâneas e de HDL colesterol, e maiores do índice de massa corporal, de circunferência do braço, de pressão arterial sistólica e diastólica, de triglicérides, de VLDL e de ácido úrico. As prevalências de sobrepeso (51,8%,), obesidade (15%), dislipidemia (77,1%) e níveis pressóricos elevados (37,7%) foram maiores entre os homens enquanto que as mulheres apresentaram maior prevalência de obesidade abdominal (52,1%), independentemente da idade e da tribo de origem. Esses achados sugerem a necessidade de implementação de medidas que visem tanto ao controle como à prevenção da obesidade e outros fatores de risco cardiovasculares entre esses indivíduos.The objective of this study was to describe the anthropometric and metabolic profile of Aruák Indians (Mehináku, Waurá, and Yawalapití) in the Upper Xingu, Central Brazil. In July 2000 and October 2002, 201 subjects of both genders and aged > 20 years were submitted to physical (anthropometric and blood pressure measures) and laboratory (fasting blood glucose, serum lipids, and uric acid) examination. As compared to females, males had lower mean skinfold thickness measurements and serum HDL cholesterol, and higher body mass index, arm circumference, systolic and diastolic blood pressure, serum triglycerides, VLDL cholesterol, and uric acid. The prevalence rates for overweight (51.8%), obesity (15%), dyslipidemia (77.1%), and hypertension (37.7%) were higher among men than women, but prevalence of abdominal obesity (52.1%) was higher among women than men, independently of age and origin. These results corroborate the need to implement measures to control and prevent obesity and other cardiovascular risk factors among these indigenous peoples.

A democratização das ações e serviços de saúde no Brasil, expressa no Sistema Único de Saúde (SUS) em 1990, tem como base novas relações entre estado e sociedade. Idealisticamente, os princípios e as diretrizes do Sistema Único de Saúde, forjados ainda no Movimento de Reforma Sanitária a partir de 1976, estabelecem o papel central do usuário e deslocam o eixo do poder das macroestruturas para os níveis locais e regionais, com a ampla participação de todos os setores que compõem o cenário da saúde. No caso indígena, o Subsistema de Atenção à Saúde Indígena no âmbito do SUS foi implementado em 1999, face às históricas desigualdades e iniqüidades vividas por esses povos no Brasil. Desde a implantação do Subsistema, há sete anos, são poucas as reflexões sobre os conceitos-chaves e sua práxis em contextos interculturais: atenção diferenciada, Agentes Indígenas de Saúde e participação e controle social. Esse artigo traz uma avaliação do modelo de atenção à saúde indígena com base nesses aspectos. A partir de pesquisas realizadas no sul do Brasil, especificamente no Estado de Santa Catarina e na experiência de participação em instâncias de controle social, buscamos contribuir para a avaliação, que é exígua até o momento.The democratization of health actions and services in Brazil, as expressed in the National Health System (SUS) established in 1990, is based upon new relations between the State and society. Ideally, the principles and directives of SUS, also created in the Health Care Reform movement from 1976 onwards, establish the central role of the consumer and shift the axis of power from macro-institutions to local and regional levels, with broad participation of all the sectors that make up the health service field. In view of the historical inequalities and inequities experienced by the indigenous peoples of Brazil, the Subsystem of Attention to Indian Health as part of SUS was established in 1999. Since the implementation of the Subsystem seven years ago, there have been few reflections regarding the praxis of its key concepts in intercultural contexts: differentiated attention, Indian Health Agents and participation and social control. Considering these aspects, this article evaluates the model of attention to Indian health. Based on research from Southern Brazil, specifically from the State of Santa Catarina, and on the experience of participation in situations of social control, the authors hope to contribute to an evaluation of the Subsystem, which is imperative at this moment.

O estudo descreve a situação da tuberculose no Município de São Gabriel da Cachoeira, Estado do Amazonas, Brasil, no período de 1997 a 2002. Este município de população predominantemente indígena constitui uma importante noso-área da Amazônia para o problema da tuberculose, cuja magnitude se expressa por intermédio do coeficiente 2,4 vezes mais elevado que a média estadual e até quatro vezes mais que a média nacional. Análises estatísticas utilizadas para avaliar a tendência em relação à associação com a idade, o sexo e a forma clínica revelaram diferenças no comportamento da endemia, quando comparados os coeficientes de incidência entre os casos de procedência urbana e rural. As taxas padronizadas mostraram a população masculina com uma incidência mais elevada que a feminina nas duas áreas de residência. A faixa etária mais atingida foi acima de 50 anos, porém a proporção de menores de 15 anos se mostrou acima dos valores esperados na população geral do país, além de apresentar diferentes níveis de gravidade nas subáreas rurais estudadas. Os achados indicam que esta situação pode ser explicada pelas desigualdades, sobretudo, relativas à acessibilidade aos serviços de saúde que, contraditoriamente, parecem menos resolutivos na área urbana.This study describes the tuberculosis situation in São Gabriel da Cachoeira, Amazonas State, Brazil, from 1997 to 2002. The county, which has a predominantly Indian population, is a relevant tuberculosis area in Amazonas, since the infection rate is 2.4 to 4 times that of the overall State and national rates. The statistical analyses used to assess its association with age, gender, and clinical form showed differences in the endemic behavior, comparing the urban and rural incidence rates. Males had higher standardized incidence rates than females in both the urban and rural areas. The most heavily affected age group was greater than 50 years, but the rate among individuals under 15 years was above the overall national rate, in addition to presenting different severity levels in the rural sub-areas that were studied. The situation can be explained mainly by inequalities in access to health services, which paradoxically appear to show lower case-resolving capacity in urban areas of the county.