Tuberculosis in indigenous children in the Brazilian Amazon

Revista de Saúde Pública

Caroline Gava²  Jocieli Malacarne²  Diana Patrícia Giraldo Rios²  Clemax Couto Sant'anna¹  Luiz Antônio Bastos Camacho¹  Paulo Cesar Basta¹ 

[1] ,Fundação Oswaldo Cruz Escola Nacional de Saúde Pública Sérgio Arouca Programa de Epidemiologia em Saúde PúblicaRio de Janeiro RJ ,Brasil

关键词: Child;    Indigenous Population;    Tuberculosis;    epidemiology;    Health Inequalities;    Disease Notification;    Underregistration;    Criança;    População Indígena;    Tuberculose;    epidemiologia;    Desigualdades em Saúde;    Notificação de Doenças;    Sub-Registro;    niño;    población indígena;    tuberculosis;    epidemiologia;    desigualdades en la salud;    notificación de enfermedad;    omisiones de registro;   

DOI  :  10.1590/S0034-89102013000100011

来源: SciELO

【 摘 要 】

OBJECTIVE: Assess the epidemiological aspects of tuberculosis in Brazilian indigenous children and actions to control it. METHODS: An epidemiological study was performed with 356 children from 0 to 14 years of age in Rondônia State, Amazon, Brazil, during the period 1997-2006. Cases of TB reported to the Notifiable Diseases Surveillance System were divided into indigenous and non-indigenous categories and analyzed according to sex, age group, place of residence, clinical form, diagnostic tests and treatment outcome. A descriptive analysis of cases and hypothesis test (χ²) was carried out to verify if there were differences in the proportions of illness between the groups investigated. RESULTS: A total of 356 TB cases were identified (125 indigenous, 231 non-indigenous) of which 51.4% of the cases were in males. In the indigenous group, 60.8% of the cases presented in children aged 0-4 years old. The incidence mean was much higher among indigenous; in 2001, 1,047.9 cases/100,000 inhabitants were reported in children aged < 5 years. Pulmonary TB was reported in more than 80% of the cases, and in both groups over 70% of the cases were cured. Cultures and histopathological exams were performed on only 10% of the patients. There were 3 cases of TB/HIV co-infection in the non-indigenous group and none in the indigenous group. The case detection rate was classified as insufficient or fair in more than 80% of the indigenous population notifications, revealing that most of the diagnoses were performed based on chest x-ray. CONCLUSIONS: The approach used in this study proved useful in demonstrating inequalities in health between indigenous and non-indigenous populations and was superior to the conventional analyses performed by the surveillance services, drawing attention to the need to improve childhood TB diagnosis among the indigenous population.

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