BackgroundIn Brazil, community health workers have gathered monthly information on people with disabilities to maintain the Primary Care Information System since 1998; however, few studies have used this database for scientific or public health policy purposes.ObjectivesThis study aimed to evaluate the reliability of information on people with disabilities gathered by community health workers in primary care services.MethodThis was a cross-sectional population-based study conducted in two highly consanguineous communities, involving a population of 18,458 inhabitants in Northeastern Brazil. To study the prevalence of people with disabilities, estimations performed by health workers were compared with those obtained by researchers who interviewed 15.6% of the total population. To study the agreement of the information, data on 106 people with disabilities completed independently by researchers and health workers were compared to evaluate the degree of agreement for 28 variables analysed. Kappa statistics (κ) were used to calculate the inter-rater agreement.ResultsThe prevalence of disability estimated by community health workers was 3.01 and 2.00% for city A and B, respectively, while the percentages obtained by researchers were 6.72 and 5.65%, respectively, showing an underestimation of prevalence according to community health workers. The Kappa index value obtained for all data analysed (2,589 items excluding losses) was 0.808 (p < 0.01), indicating an almost perfect consistency of information collected by health workers compared to by researchers.ConclusionCommunity health workers collected information with a high degree of reliability, although the identification of the prevalence of disabled individuals was potentially impaired due to the work process.
This paper deals with the frequency and structure of first-cousin marriages, by far the most important and frequent type of consanguineous mating in human populations. Based on the analysis of large amounts of data from the world literature and from large Brazilian samples recently collected, we suggest some explanations for the asymmetry of sexes among the parental sibs of first-cousin marriages. We suggest also a simple manner to correct the method that uses population surnames to assess the different Wright fixation indexes FIS, FST and FIT taking into account not only alternative methods of surname transmission, but also the asymmetries that are almost always observed in the distribution of sexes among the parental sibs of first-cousins.
The aim of this cross-sectional study was to investigate beliefs, attitudes and reproductive behaviours in relation to consanguinity in a population living in the backlands of north-eastern Brazil. Data were collected by face-to-face interview from 147 high school students aged 13–20 years and from 532 elderly individuals aged 60 years and over from Brejo dos Santos in the state of Paraíba in 2017. The frequency of consanguineous marriage was found to have increased over the generations, being 15.9% in the parents of the elderly participants, 17.1% in the elderly participants themselves and 20.5% in their descendants. Although 258 (50.9%) of the elderly interviewees opposed consanguineous union, 341 (65.3%) would approve of the marriage of their children with relatives. Both the young (n=108 or 78.3%) and elderly (n=398 or 80.4%) interviewees believed that consanguineous marriages were no more durable than non-consanguineous marriages (p=0.578). Additionally, 408 (82.4%) of the elderly individuals and 108 (80.6%) of the students recognized that spouses in consanguineous unions experience conflicts, just like other couples do (p=0.625). In both groups, the majority of the participants did not believe that consanguinity increased the risk of having children with disabilities. The regression of the two continuous variables ‘age’ and ‘positive attitudes score’ showed a significant correlation, suggesting that younger individuals are more susceptible to the influence of cultural factors contributing to consanguinity, such as the opinions of their parents and grandparents. The belief that consanguineous unions are more durable showed a significant difference between elderly individuals in consanguineous and non-consanguineous unions (p=0.001); the former were 2.42 more likely to believe that marriages between relatives contributes to marriage durability.
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