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Genetic determinants and absence of breast cancer in Xavante Indians in Sangradouro Reserve, Brazil. Sci Rep 2023; 13:1452. [PMID: 36702877 PMCID: PMC9879933 DOI: 10.1038/s41598-023-28461-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 01/18/2023] [Indexed: 01/27/2023] Open
Abstract
Genetic compositions of distinct human populations are different. How genomic variants influence many common and rare genetic diseases is always of great medical and anthropological interest, and understanding of genetic architectures of population groups in relation to diseases can advance our knowledge of medicine. Here, we have studied the genomic architecture of a group of Xavante Indians, an indigenous population in Brazil, and compared them with normal populations from the 1000 Genomes Projects. Principal component analysis (PCA) indicates that the Xavante Indians are genetically distinctive when compared to other ethnic groups. No incidence of breast cancer cases has ever been reported in the population, and polygenic risk analysis indicates extremely low breast cancer risk in this population when compared with germline TCGA (The Cancer Genome Atlas) breast cancer normal control samples. Low germinal mutation burden among this population is also observed. Our findings will help to deepen the understanding of breast cancer and might also provide new approaches to study the disease.
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Chew CC, Lim XJ, Low LL, Lau KM, Kari M, Shamsudin UK, Rajan P. The challenges in managing the growth of indigenous children in Perak State, Malaysia: A qualitative study. PLoS One 2022; 17:e0265917. [PMID: 35320328 PMCID: PMC8942260 DOI: 10.1371/journal.pone.0265917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/09/2022] [Indexed: 11/25/2022] Open
Abstract
Indigenous peoples in Peninsular Malaysia, known as Orang Asli, have been associated with the problem of malnutrition. Approximately 40% of their children are underweight. Indigenous peoples' distinct social, cultural, and economic traits, which differ from those of the dominant communities in which they live, may pose significant challenges for health care providers (HCPs) in addressing the malnutrition issue. This study explores challenges encountered by HCPs, with at least six months of experience in monitoring the growth parameters of Orang Asli children residing in Perak State in Peninsular Malaysia. A cross-sectional study was conducted between December 2020 and June 2021, involving three focus group discussions and three in-depth interviews. Thematic analysis was used. A total of 19 participants (6 nurses, 5 nursing managers, 4 medical officers, 2 nutritionists, a family medicine specialist, and a paediatrician) took part in this study. The challenges were summarized into four themes: (I) accessibility to nutrition, (II) accessibility to healthcare services, (II) skills of HCPs, and (IV) challenges of implementing nutrition programs. The inability of the Orang Asli children to access nutritious food was due to poverty, different perceptions of life priorities, and the practice of food taboos among the communities. Inadequate infrastructure and transportation discourage parents from bringing their children to healthcare facilities. The belief in and preference for traditional healing, the practice of semi-nomadic lifestyles, and fear of HCPs and their timid nature were factors that prevented Orang Asli children from accessing healthcare services. HCPs need to equip themselves with cross-cultural communication and interaction skills and adapt their skills to environmental challenges to overcome unexpected encounters in mobile clinics. The non-exposed food items, the risk of food basket sharing with other family members, and community feeding programs' coordination were the challenges to be addressed when implementing nutrition programmes for Orang Asli children. The challenges of HCPs are multifactorial and require a multifaceted approach. There is a need for joint efforts of stakeholders, from communities and non-governmental organisations (NGOs) to the health authorities, to address the challenges of HCPs.
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Affiliation(s)
- Chii-Chii Chew
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Ipoh, Malaysia
| | - Xin-Jie Lim
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Ipoh, Malaysia
| | - Lee-Lan Low
- Institute for Health Systems Research, Ministry of Health, Ipoh, Malaysia
| | - Kin-Mun Lau
- Perak State Health Department, Ministry of Health, Ipoh, Ipoh, Malaysia
| | - Maziana Kari
- Perak State Health Department, Ministry of Health, Ipoh, Ipoh, Malaysia
| | | | - Philip Rajan
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Ipoh, Malaysia
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Oliveira MVGD, Marinho GL, Abreu ÂMM. A população indígena Xavante em Mato Grosso: características sociodemográficas relacionadas à saúde. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0084pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo Comparar indicadores sociodemográficos dos Xavante de seis terras indígenas com a população não indígena residente em áreas rurais de quatro microrregiões adjacentes. Método Estudo seccional, do tipo ecológico, com análises comparativas entre indígenas e não indígenas residentes no estado de Mato Grosso, Brasil. Compararam-se os seguintes indicadores: estrutura etária e por sexo, taxa de alfabetização, renda, condições de saneamento dos domicílios e mortalidade. Resultados Foram caracterizadas 14.905 pessoas Xavante e 78.106 pessoas não indígenas (brancas, pretas, amarelas e pardas) residentes em domicílios de área rural. A estrutura etária revelou padrões divergentes, 40,0% dos Xavantes tinham menos de 10 anos de idade, contra 15,0% dos não indígenas na mesma faixa etária. Em relação aos não indígenas, os Xavantes apresentaram maior taxa de analfabetismo (31,3% vs. 9,9%) e 84,1% dos domicílios não possuíam banheiro ou sanitário, 39,6% das pessoas Xavante não declararam renda, contra 6,5% para os não indígenas. Conclusão e implicação para a prática Os dados sobre etnia, coletados pela primeira vez por um censo, são essenciais para análises demográficas de segmentos específicos da população, e, no caso dos Xavante, revelam desigualdades em relação aos não indígenas.
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Oliveira MVGD, Marinho GL, Abreu ÂMM. The Xavante indigenous population in Mato Grosso: health-related sociodemographic characteristics. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0084en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective To compare Xavante sociodemographic indicators from six indigenous lands with the non-indigenous population residing in rural areas of four adjacent microregions. Method This is an ecological cross-sectional study, with comparative analyzes between indigenous and non-indigenous residents in the state of Mato Grosso, Brazil. Age and sex structure, literacy rate, income, household sanitation conditions and mortality were compared. Results A total of 14,905 Xavante people and 78,106 non-indigenous people (white, black, yellow and brown) residing in rural areas were characterized. The age structure revealed divergent patterns, 40.0% of Xavante were under 10 years old, against 15.0% of non-indigenous people in the same age group. Regarding non-indigenous people, the Xavante had a higher illiteracy rate (31.3% vs. 9.9%), and 84.1% of the households did not have a bathroom or toilet, 39.6% of Xavante people did not declare an income against 6.5% for the non-indigenous. Conclusion and implication for practice Data on ethnicity, collected for the first time by a census, are essential for demographic analyzes of specific segments of the population, and in the case of the Xavante, they reveal inequalities in relation to non-indigenous people.
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Islam MA, Afroja S, Khan MS, Alauddin S, Nahar MT, Talukder A. Prevalence and Triggering Factors of Childhood Anemia: An Application of Ordinal Logistic Regression Model. Int J Clin Pract 2022; 2022:2212624. [PMID: 35685513 PMCID: PMC9159194 DOI: 10.1155/2022/2212624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/17/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Anemia is indeed a significant risk factor for children's health as it affects growth retardation and has severe short and prolonged effects that follow in morbidity and death. Notwithstanding such ways to tackle anemia, the prevalence remains high in India and poses a severe public health concern. OBJECTIVES The primary focus of this study was to find the prevalence and to determine the factors associated with the anemia of children under five years of age in India. Problem Statement. The increasing prevalence of childhood anemia and the life-threatening consequences for millions of children in India are a major concern. Knowing the relevant associated factors with childhood anemia is essential to reduce the frequency and severity level. Study design. For analysis purposes, this study utilized a cross-sectional study design. Methodology. Using the Indian Demographic and Health Survey 2015-16 data, we used chi-squared and gamma tests to find the association. Then, we utilized multinomial logistic regression and ordinal logistic regression to find the better model and the influencing factors of anemia in India. RESULTS In our study, we have found that children with highly educated mothers were 36.7% less likely (OR = 0.633, P ≤ 0.001, 95% CI: 0.608, 0.658) to be higher anemic than the children with not educated mother. Children with moderate and severe anemic mothers were 163.3% (OR = 2.633, P ≤ 0.001, 95% CI: 2.565, 7.704) more likely to be higher anemic than the children with not anemic mother. Not stunting children were 21.9% (OR = 0.781, P ≤ 0.001, 95% CI: 0 .764, 0.797) less likely to be higher anemic than the stunting children. Children aged 36-59 months were 73.9% (OR = 0.361, P ≤ 0.001, 95% CI: 0.353, 0.369) less likely to be higher anemic than the children aged 6-24 months. Again, the ACI value revealed that ordinal logistic regression was a better-fitted model for these data. CONCLUSION and contribution. The variables such as stunting, underweight, wasting, child age, size of the child, and source of drinking water were the most critical indicators for child anemia in India. In summary, our study result indicated the major socioeconomic and demographic factors associated with childhood anemia in India, which can help the policymaker to take quick decision to reduce the severity level.
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Affiliation(s)
- Md. Akhtarul Islam
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna 9208, Bangladesh
| | - Sohani Afroja
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna 9208, Bangladesh
| | - Md. Salauddin Khan
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna 9208, Bangladesh
| | - Sharlene Alauddin
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna 9208, Bangladesh
| | - Mst. Tanmin Nahar
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna 9208, Bangladesh
| | - Ashis Talukder
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna 9208, Bangladesh
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Ecological analysis of adolescent birth rates in Brazil: Association with Human Development Index. Women Birth 2020; 33:e191-e198. [DOI: 10.1016/j.wombi.2019.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/02/2019] [Accepted: 04/05/2019] [Indexed: 01/06/2023]
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Afroja S, Kabir MR, Islam MA. Analysis of determinants of severity levels of childhood anemia in Bangladesh using a proportional odds model. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2019.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Thiede BC, Gray C. Characterizing the Indigenous Forest Peoples of Latin America: Results from Census Data. WORLD DEVELOPMENT 2020; 125:10.1016/j.worlddev.2019.104685. [PMID: 32123463 PMCID: PMC7051013 DOI: 10.1016/j.worlddev.2019.104685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Indigenous populations in Latin America are central to regional and global efforts toward achieving socially and environmentally sustainable development. However, existing demographic research on indigenous forest peoples (IFPs) has many limitations, including a lack of comparable cross-national evidence. We address this gap by linking representative census microdata to satellite-derived tree cover estimates for nine countries in the region. Our analyses describe the demographic and socioeconomic characteristics of IFPs, and draw comparisons with reference groups. Our first goal is to examine within- and between-population variation in the age structure, human capital attainment, and economic status of IFPs. We then analyze patterns of fertility among indigenous forest-dwelling women and comparison groups. Finally, we examine the association between migration patterns and tree cover among indigenous and non-indigenous populations. Findings demonstrate that Latin America's IFPs are materially deprived and characterized by high fertility levels overall. Importantly for sustainable development efforts, we show that non-indigenous forest-dwellers outnumber IFPs by more than eight to one and that IFPs have lower fertility than their non-indigenous counterparts when other characteristics are accounted for. Additionally, we find that most in-migrants to heavily-forested areas are non-indigenous, and that in-migrants tend to settle in areas that are forested but have few indigenous inhabitants. These results provide new cross-national evidence on the state of IFPs in Latin America, and highlight the need to empower these groups in the face of growing social and environmental crises in the region.
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Affiliation(s)
- Brian C. Thiede
- Corresponding Author: Department of Agricultural Economics, Sociology, and Education, The Pennsylvania State University, 111A Armsby Building, University Park, PA 16802, , 814-865-2561
| | - Clark Gray
- The University of North Carolina at Chapel Hill
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Ferreira AA, Santos RV, Souza JAMD, Welch JR, Coimbra Jr CEA. Anemia e níveis de hemoglobina em crianças indígenas Xavante, Brasil Central. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 20:102-114. [DOI: 10.1590/1980-5497201700010009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 08/31/2016] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Objetivo: Avaliar a prevalência de anemia, os níveis médios de hemoglobina e os principais fatores nutricionais, demográficos e socioeconômicos associados em crianças Xavante, em Mato Grosso, Brasil. Métodos: Realizou-se inquérito em duas comunidades indígenas Xavante na Terra Indígena Pimentel Barbosa visando avaliar todas as crianças com menos de dez anos. Foram coletados dados de concentração de hemoglobina, antropometria e aspectos socioeconômicos/demográficos por meio de avaliação clínica e questionário estruturado. Utilizaram-se os pontos de corte recomendados pela Organização Mundial da Saúde (OMS) para a classificação de anemia. Análises de regressão linear com hemoglobina como desfecho e regressão de Poisson com variância robusta com presença ou não de anemia como desfechos foram realizadas (intervalo de confiança de 95% -IC95%). Resultados: Os menores valores médios de hemoglobina ocorreram nas crianças com menos de dois anos, sem diferença significativa entre os sexos. A anemia atingiu 50,8% das crianças, prevalecendo aquelas com menos de dois anos 2 anos (77,8%). A idade associou-se inversamente à ocorrência de anemia (razão de prevalência - RP - ajustada = 0,60; IC95% 0,38 - 0,95) e os valores médios de hemoglobina aumentaram significativamente conforme o incremento da idade. Os maiores valores de escores z de estatura-para-idade reduziam em 1,8 vez a chance de ter anemia (RP ajustada = 0,59; IC95% 0,34 - 1,00). A presença de outra criança com anemia no domicílio aumentou em 52,9% a probabilidade de ocorrência de anemia (RP ajustada = 1,89; IC95% 1,16 - 3,09). Conclusão: Elevados níveis de anemia nas crianças Xavante sinalizam a disparidade entre esses indígenas e a população brasileira geral. Os resultados sugerem que a anemia é determinada por relações complexas e variáveis entre fatores socioeconômicos, sociodemográficos e biológicos.
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Dietary Diversity Is Not Associated with Haematological Status of Pregnant Women Resident in Rural Areas of Northern Ghana. J Nutr Metab 2017; 2017:8497892. [PMID: 28168052 PMCID: PMC5267082 DOI: 10.1155/2017/8497892] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/20/2016] [Accepted: 12/18/2016] [Indexed: 11/29/2022] Open
Abstract
Background. Information regarding how dietary diversity is related to haematological status of the pregnant women in rural areas of Northern Ghana is limited. This study therefore evaluated maternal dietary intake and how it relates to the nutritional status of pregnant women belonging to different socioeconomic conditions in Northern Ghana. Methods. This study was cross-sectional in design involving 400 pregnant women. Midupper arm circumference (MUAC) and anaemia status were used to assess the nutritional status of pregnant women. Results. The mean dietary diversity score (DDS) of the study population from ten food groups was 4.2 ± 1.5 (95% CI: 4.08 to 4.37). Of the 400 women, 46.1% (95% CI: 40.0 to 52.2) met the new minimum dietary diversity for women (MDD-W). The mean haemoglobin concentration among the pregnant women studied was 10.1 g/dl ± 1.40 (95% CI: 9.8 to 10.3). The independent predictors of haemoglobin concentration were maternal educational attainment, gestational age, frequency of antenatal care (ANC) attendance, number of under-five children in the household, size of MUAC, and maternal height. Conclusions. Irrespective of the socioeconomic status, women minimum dietary diversity (MDD-W) was not associated with anaemia among pregnant women resident in the rural areas of Northern Ghana.
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Ferreira AA, Welch JR, Cunha GM, Coimbra CEA. Physical growth curves of indigenous Xavante children in Central Brazil: results from a longitudinal study (2009–2012). Ann Hum Biol 2016; 43:293-303. [DOI: 10.1080/03014460.2016.1195445] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Aline A. Ferreira
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - James R. Welch
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | - Carlos E. A. Coimbra
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Campos SBG, de Menezes RCE, Oliveira MAA, Silva DAVD, Longo‐Silva G, Oliveira JS, Asakura L, Costa EC, Leal VS. Déficit estatural em crianças do povo Karapotó, São Sebastião, Alagoas, Brasil. REVISTA PAULISTA DE PEDIATRIA 2016; 34:197-203. [DOI: 10.1016/j.rpped.2015.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 08/14/2015] [Accepted: 08/30/2015] [Indexed: 10/22/2022]
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Campos SBG, de Menezes RCE, Araújo Oliveira MA, da Silva DAV, Longo-Silva G, Oliveira JS, Asakura L, Costa EC, Leal VS. Short stature in children of Karapotó ethnic background, São Sebastião, Alagoas, Brazil. REVISTA PAULISTA DE PEDIATRIA (ENGLISH EDITION) 2016. [PMID: 26652132 PMCID: PMC4917271 DOI: 10.1016/j.rppede.2016.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Objective: Methods: Results: Conclusions:
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Khan JR, Awan N, Misu F. Determinants of anemia among 6-59 months aged children in Bangladesh: evidence from nationally representative data. BMC Pediatr 2016; 16:3. [PMID: 26754288 PMCID: PMC4707771 DOI: 10.1186/s12887-015-0536-z] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 12/12/2015] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Anemia is a global public health problem but the burden of anemia is disproportionately borne among children in developing countries. Anemia in early stages of life has serious consequences on the growth and development of the children. We examine the prevalence of anemia, possible association between anemia and different socio-economic, demographic, health and other factors among children with ages from 6 to 59 months from the nationally representative 2011 Bangladesh Demographic and Health Survey (BDHS). METHODS Data on hemoglobin (Hb) concentration among the children aged 6-59 months from the most recent BDHS (2011) were used. This nationally representative survey allowed a multistage stratified cluster sampling design and provided data on a wide range of indicators such as fertility, mortality, women and child health, nutrition and other background characteristics. Anemia status was determined using hemoglobin level (<11.0 g/dl), and weighted prevalence of childhood anemia along with 95 % confidence intervals were provided. We also examined the distribution of weighted anemia prevalence across different groups and performed logistic regression to assess the association of anemia with different factors. RESULTS A total of 2171 children aged 6-59 months were identified for this analysis, with weighted prevalence of anemia being 51.9 % overall- 47.4 % in urban and 53.1 % in rural regions. Results of a multivariable logistic regression analysis showed that, children below 24 months of age (odds ratio, [OR] 3.01; 95 % confidence interval [CI] 2.38-3.81), and those from an anemic mother (OR 1.80; 95 % CI 1.49-2.18) were at higher risk of anemia. Childhood anemia was significantly associated with chronic malnutrition of child, source of drinking water, household wealth and geographical location (defined by division). CONCLUSIONS A high prevalence of anemia among 6-59 months aged children was observed in Bangladesh. Given the negative impact of anemia on the development of children in future, there is an urgent need for effective and efficient remedial public health interventions.
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Affiliation(s)
- Jahidur Rahman Khan
- Centre for Nutrition and Food Security, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh.
| | - Nabil Awan
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh.
| | - Farjana Misu
- Department of Agricultural Statistics, Bangladesh Agricultural University, Mymensingh, Bangladesh.
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Carlos Jr. EAC. Saúde e povos indígenas no Brasil: reflexões a partir do I Inquérito Nacional de Saúde e Nutrição Indígena. CAD SAUDE PUBLICA 2014; 30:855-9. [DOI: 10.1590/0102-311x00031214] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 03/12/2014] [Indexed: 11/21/2022] Open
Abstract
A configuração atual da saúde dos povos indígenas no Brasil resulta de complexa trajetória histórica, responsável por grandes atrasos para os indígenas em relação aos avanços sociais verificados no país ao longo das últimas décadas, particularmente nos campos da saúde, educação, habitação e saneamento. O principal foco dessa contribuição é rever sinteticamente uma seleção dos principais resultados do I Inquérito Nacional de Saúde e Nutrição Indígena, realizado entre 2008-2009, e que visitou 113 aldeias em todo o país, tendo entrevistado 6.692 mulheres e 6.128 crianças. Dentre os resultados, é dado destaque às deficientes condições de saneamento verificadas nas aldeias, à elevada prevalência de desnutrição crônica, anemia, diarreia e infecções respiratórias agudas na criança, e à emergência de doenças crônicas não transmissíveis na mulher. O cenário delineado a partir do Inquérito impõe urgente revisão crítica da política de saúde indígena, com vistas a melhor atender às necessidades de saúde do segmento indígena da população brasileira.
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Leite MS, Cardoso AM, Coimbra CEA, Welch JR, Gugelmin SA, Lira PCI, Horta BL, Santos RV, Escobar AL. Prevalence of anemia and associated factors among indigenous children in Brazil: results from the First National Survey of Indigenous People's Health and Nutrition. Nutr J 2013; 12:69. [PMID: 23714275 PMCID: PMC3681561 DOI: 10.1186/1475-2891-12-69] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 05/15/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anemia is the most prevalent nutritional deficiency globally, affecting about a quarter of the world population. In Brazil, about one-fifth of children under five years of age are anemic. Previous case studies indicate prevalence rates much higher among indigenous peoples in the country. 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 anemia and associated factors among indigenous children in Brazil. 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. Prevalence rates of anemia were calculated for independent variables and hierarchical multivariate analysis were conducted to assess associations. RESULTS Evaluation of hemoglobin levels was conducted for 5,397 children (88.1% of the total sample). The overall prevalence of anemia was 51.2%. Higher risk of presenting anemia was documented for boys, lower maternal schooling, lower household socioeconomic status, poorer sanitary conditions, presence of maternal anemia, and anthropometric deficits. Regional differences were observed, with the highest rate being observed in the North. CONCLUSIONS The prevalence rates of anemia in indigenous children were approximately double than those reported for non-indigenous Brazilian children in the same age group. Similarly notable differences in the occurrence of anemia in indigenous and non-indigenous children have been reported for other countries. Deeper knowledge about the etiology of anemia in indigenous children in Brazil is essential to its proper treatment and prevention.
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Affiliation(s)
- Maurício S Leite
- Departamento de Nutrição, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC 88040-900, Brazil
| | - Andrey M Cardoso
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210, Brazil
| | - Carlos EA Coimbra
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210, Brazil
| | - James R Welch
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210, Brazil
| | - Silvia A Gugelmin
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Av. Fernando Correa da Costa 2367, Cuiabá, MT 78060-900, Brazil
| | - Pedro Cabral I Lira
- Departamento de Nutrição, Universidade Federal de Pernambuco, Avenida Professor Moraes Rego 1235, Recife, PE 50670-901, Brazil
| | - Bernardo L Horta
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Rua Marechal Deodoro 1160, Pelotas, RS 96020-220, Brazil
| | - Ricardo Ventura Santos
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210, Brazil
- Departamento de Antropologia, Museu Nacional, Universidade Federal do Rio de Janeiro, Quinta da Boa Vista s/n, Rio de Janeiro, RJ 20940-040, Brazil
| | - Ana Lúcia Escobar
- Departamento de Ciências Biomédicas, Universidade Federal de Rondônia, Rodovia BR-364 Km 9.5, Porto Velho, RO 76801-059, Brasil
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Horta BL, Santos RV, Welch JR, Cardoso AM, dos Santos JV, Assis AMO, Lira PCI, Coimbra Jr CEA. Nutritional status of indigenous children: findings from the First National Survey of Indigenous People's Health and Nutrition in Brazil. Int J Equity Health 2013; 12:23. [PMID: 23552397 PMCID: PMC3637628 DOI: 10.1186/1475-9276-12-23] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 03/26/2013] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The prevalence of undernutrition, which is closely associated with socioeconomic and sanitation conditions, is often higher among indigenous than non-indigenous children in many countries. In Brazil, in spite of overall reductions in the prevalence of undernutrition in recent decades, the nutritional situation of indigenous children remains worrying. The First National Survey of Indigenous People's Health and Nutrition in Brazil, conducted in 2008-2009, was the first study to evaluate a nationwide representative sample of indigenous peoples. This paper presents findings from this study on the nutritional status of indigenous children < 5 years of age in Brazil. METHODS A multi-stage sampling was employed to obtain a representative sample of the indigenous population residing in villages in four Brazilian regions (North, Northeast, Central-West, and Southeast/South). Initially, a stratified probabilistic sampling was carried out for indigenous villages located in these regions. Households in sampled villages were selected by census or systematic sampling depending on the village population. The survey evaluated the health and nutritional status of children < 5 years, in addition to interviewing mothers or caretakers. RESULTS Height and weight measurements were taken of 6,050 and 6,075 children, respectively. Prevalence rates of stunting, underweight, and wasting were 25.7%, 5.9%, and 1.3%, respectively. Even after controlling for confounding, the prevalence rates of underweight and stunting were higher among children in the North region, in low socioeconomic status households, in households with poorer sanitary conditions, with anemic mothers, with low birthweight, and who were hospitalized during the prior 6 months. A protective effect of breastfeeding for underweight was observed for children under 12 months. CONCLUSIONS The elevated rate of stunting observed in indigenous children approximates that of non-indigenous Brazilians four decades ago, before major health reforms greatly reduced its occurrence nationwide. Prevalence rates of undernutrition were associated with socioeconomic variables including income, household goods, schooling, and access to sanitation services, among other variables. Providing important baseline data for future comparison, these findings further suggest the relevance of social, economic, and environmental factors at different scales (local, regional, and national) for the nutritional status of indigenous peoples.
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Affiliation(s)
- Bernardo L Horta
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Rua Marechal Deodoro 1160, Pelotas, RS, 96020-220, Brazil
| | - Ricardo Ventura Santos
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ, 21041-210, Brazil
- Departamento de Antropologia, Museu Nacional, Universidade Federal do Rio de Janeiro, Quinta da Boa Vista s/n, Rio de Janeiro, RJ, 20940-040, Brazil
| | - James R Welch
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Andrey M Cardoso
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Janaína Vieira dos Santos
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Rua Marechal Deodoro 1160, Pelotas, RS, 96020-220, Brazil
| | | | - Pedro CI Lira
- Departamento de Nutrição, Universidade Federal de Pernambuco, Avenida Professor Moraes Rego 1235, Recife, PE, 50670-901, Brazil
| | - Carlos EA Coimbra Jr
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ, 21041-210, Brazil
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Ferreira AA, Welch JR, Santos RV, Gugelmin SA, Coimbra CEA. Nutritional status and growth of indigenous Xavante children, Central Brazil. Nutr J 2012; 11:3. [PMID: 22236407 PMCID: PMC3317817 DOI: 10.1186/1475-2891-11-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 01/11/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to characterize the nutritional status of Xavante Indian children less than 10 years of age in Central Brazil and to evaluate the hypothesis of an association between child nutrition and socioeconomic differentiation in this population. METHODS A cross-sectional study was conducted in July 2006 that included all children under the age of 10 from the Xavante village Pimentel Barbosa in Mato Grosso, Brazil. The data collected included weight, height, and sociodemographic information. Sociodemographic data were used to generate two indices ("income" and "wealth") and to determine the proportion of adults in each household. Descriptive analyses were performed for weight-for-age (W/A), height-for-age (H/A), and weight-for-height (W/H) using the NCHS and the WHO growth references. Univariate and multivariate analyses were conducted using H/A and W/A as a response variables. RESULTS Of a total of 246 children under the age of ten residing in the village, 232 (94.3%) were evaluated. Following the NCHS reference, 5.6% of children under the age of ten presented low W/A and 14.7% presented low H/A. Among children under the age of five, deficit percentages for weight and height were 4.5% and 29.9%, respectively, following the WHO curves. Among children < 2 years of age, H/A index variability was found to be directly related to child's age and inversely related to the proportion of adults in the household. Maternal BMI was positively associated with growth for children from 2 to 4 years of age, explaining 11.5% of the z-score variability for the H/A index. For children 5 years of age and older, the wealth index and maternal height were positively associated with H/A. No significant associations were found using W/A as the dependent variable. CONCLUSION This study demonstrated that undernutrition, in particular linear growth deficit, is a notable health issue for Xavante children. These findings contrast with the nutritional profile observed among Brazilian children nationally, which is characterized by a sharp decline in child undernutrition in recent decades, even in the poorest regions of the country. This discrepancy calls attention to the persistent health disparities that exist between indigenous and non-indigenous people in Brazil.
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Affiliation(s)
- Aline A Ferreira
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - James R Welch
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Ricardo V Santos
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Departamento de Antropologia, Museu Nacional, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Silvia A Gugelmin
- Departamento de Nutrição Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos EA Coimbra
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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