Referred morbidity of an African descendant community in the eastern Amazonia

Background

In the Amazon there are several quilombola communities, remnants of the enslaved peoples of African descendant. In Pará/Brazil (Eastern Amazonia) there are over 300 quilombola communities established in rural areas. The aim of this study is to investigate the living conditions and morbidity of individuals aged 18+ years who live in a quilombola community in the city of Ananindeua/Pará.

Methods

A cross-sectional study was done with 132 individuals (71.3% of the population). A household survey and a questionnaire evaluating socioeconomic, life habits and self-reported morbidity were conducted.

Results

Among the participants 90.2% belonged to the D/E economic class, 60.6% were women, the median age was 39.5 years (p = 0.343) and the per capita income was U$41.50/month with no difference between sexes (p = 0.266). 97.0% of the participants self-declared black or brown. Women had more education than men (7x5 years, p = 0.019). Most worked with agriculture and fishing (55.5%). 53.8% of men rated their health status as good while 41.0% of women rated their health as good (p = 0.002). 55.3% had never smoked cigarettes, 25.8% were ex-smokers, and 25.8% were smokers. More men (78.8%) used alcohol regularly than women (43.8%) (p = 0.000), among the users 32.5% reported weekly or daily use. The frequency of self-reported morbidity was as follows: Asthma 21.7%, Hypertension 10.6%, Diabetes 6.8%, Chronic infectious diseases 5.6%, Kidney disease 3.9%, Stroke 3.3%, Angina 3.1%, Liver disease 2.3%, Chronic heart failure 1.5%, with no difference between the sexes. Only 4.0% used medication for diabetes, and 7.6% for hypertension.

Conclusions

The study shows the social vulnerability of this quilombola community, which is similar to others in the region. The rural afro-derived Amazonian populations need to be empowered to help inform policy makers about their main health issues and healthcare needs.

Key messages

There are few studies about health of quilombola communities. This research shows the need for further investigations to produce sensible information and promote the empowerment of these populations. This study shows a high level of vulnerability of this community, similar to others in rural Amazon. Information about their health needs is fundamental to promotion of public policies in the region.

[First autochthonous cases, caused by the Dengue-3 serotype in Federal District, Brazil]

During the first four months of 2003, the survey laboratory of the Federal District (LACEN Laboratory of Virology), Brasília, Brazil, isolated ten strains of dengue virus serotype 3, five of them autochthonous, and the remaining ones from cases imported from Tocantins, Goias and Bahia States. The virus isolations were performed in C6/36 cell culture inoculated with total blood collected between the 1st and the 5th days after the onset of the symptoms. The age of the patients varied from 26 to 59 years old. The strains were typed as DEN-3 by indirect immunofluorescence assay using serotype-specific monoclonal antibodies. Viral RNAs were extracted from total blood using the trizol method. The nested RT-PCR method detected DNA products of 290 bp, confirming the serotype identifications. The introduction of DEN-3 in Brazil and especially in the Federal District represents a serious threat, since most people are susceptible to this serotype and many have already been infected by serotypes DEN-1 or DEN-2, thus increasing the risk of epidemic of more severe forms of the disease. The use of a fast and reliable method for continuous monitoring of the circulation of this serotype is of primary importance for the prevention and control of future epidemics.

Blood pressure, seasonal body fat, heart rate, and ecological differences in Caboclo populations of the Brazilian Amazon

This study compares blood pressure (BP) and related cardiovascular risk factors among three Caboclo communities from the Brazilian Amazon. Its purpose is to investigate possible risk differentials related to variable ecological settings and Western influences. Caxiuanã is characterized as a more "traditional" group, while Aracampina and Santana are viewed as more "transitional" in lifestyle. A total of 348 subjects from the three communities were evaluated in the wet or the dry season or in both. Measurements across the communities were compared by season and sex. Results suggest little seasonal variation in average BP, BP change, body fat, or body fat change among men. Conversely, there is substantial seasonal and inter-community variation among women. Additional analyses reveal (1) an inconsistent association between age and BP across the communities; (2) that BMI is not associated with BP transitional communities in either season but is associated with both systolic and diastolic pressure in the most traditional community; and (3) little to no sex effect on BP. These results suggest increased Western influence affects body composition particularly of women. However, increased BMI and fat among transitional Caboclo women does not directly translate into higher BP; rather, their BP appears to be more affected by seasonal stresses. Finally, conditions during the wet season diminish age-related variation in BP, suggesting that during the wet season these Caboclo may be less active.

Secular trends in age at menarche among Caboclo populations from Pará, Amazonia, Brazil: 1930-1980

The present study is part of a large research project on growth, development, nutrition, and health of Caboclo populations from the Brazilian Amazon. The aim of this paper is to analyze the age of menarche in adolescents (N=164) and adult women (219) in the studied populations. Caboclo are admixed rural, peasant groups that live along the Amazon river and its tributaries, and there are few previous studies about them. Probit analysis of the status quo data yielded a median age at menarche of 12.29+/-1.76 years. The retrospective method was applied to recall data of the 77 post-menarcheal adolescents, yielding an average of 13.06+/-1.27 years. Number of children in the family did not show any statistical influence on age at menarche in any age group. In adult women, age at menarche decreased from 14.50 in those born in 1930 to 12.88 for those born in 1980 (F=4.371, P=0.001). The downward trend found was, on average, 0.237 year per decade in the study period. The median age at menarche in the adolescents (12.29 years) is one of the lowest values found for Central and South American populations. In the ecological context, a low age at menarche could be an adaptive advantage because it provides a greater chance for reproduction at a young age in an environment where, until recently, life expectancy was low. As has been reported for other developing countries, the change found in age at menarche in the women born from the 1930s to the 1980s is likely to be related to changes in health and nutritional factors that occurred in Brazil because this country experienced significant improvement in living standards related to education, vaccination, and health conditions, which, although not equally, reached all regions after the 1960s.