Incidência da tuberculose em indígenas do município de São Gabriel da Cachoeira, AM

Abstract

A partir de 1999, no município de São Gabriel da Cachoeira, Amazonas, foi implementado pelo Ministério da Saúde o Programa de Controle de Tuberculose. Com o objetivo de verificar se a estratégia promoveu mudanças na incidência da tuberculose entre indígenas daquela região, foram estudados, retrospectivamente, os registros médicos de 768 pacientes, divididos em dois grupos. Constituíram o Grupo I os casos tratados entre 1994 e 1998 e o Grupo II os pacientes tratados entre 1999 e 2003. A taxa anual média de incidência foi de 239 e 284 casos de todas as formas de tuberculose por 100.000 habitantes, houve predomínio da forma pulmonar, com 88,2% e 85,9% dos casos e índices de cura elevados, representando 97,2% e 91,5%, respectivamente nos Grupos I e II. Não houve impacto na redução da taxa de incidência da doença, na comparação entre os dois períodos citados, evidenciando que persiste alto risco de aquisição de tuberculose entre indígenas daquela região.

Situação epidemiológica da tuberculose no Rio Grande do Sul: uma análise com base nos dados do Sinan entre 2003 e 2012 com foco nos povos indígenas

“…The age distribution of cases points to its concentration among young adults and to a profile that is particularly different in the indigenous segment, in which the percentage of children aged less than 10 years is about four times higher than that observed in the other segments of race/color. This profile was also observed in other studies conducted among indigenous peoples [6][7][8]11,12,15,25 . As a possible explanation for this dynamics, Gava et al point to the active transmission in indigenous communities and to flaws in the process of following up the cases and of identifying the bacillus early, which would contribute to the propagation of the disease among children 26 .…”

“…Machado Fiho 12 observed, among indigenous peoples in the Amazon region, positive bacilloscopy in only 34% of the cases, which is below expected according to the rules of the National Program of Tuberculosis Control 1 . In a series of other studies, the positive results rarely overcome 50% 5,9,12,15,23 .…”

“…Concerning specifically the situation of tuberculosis in the indigenous populations and its comparative dimension, the situation in Rio Grande do Sul is similar to that described in other studies conducted in the country, both addressing indigenous peoples, specifically, or including data about race/color in the analyses. However, this set of studies has pointed out to even more severe situations, when the indigenous segment systematically presents higher incidence rates than those registered in the other segments [4][5][6][7][8][9][10][11][12][13][14][15][16][21][22][23][24][25][26] .…”

“…Concerning the studies already conducted among indigenous peoples in the country, the incidence rates of tuberculosis are expressive when compared to those observed in the other population segments in terms of race/color. The incidence rates reach over 2,000 cases per 100,000 inhabitants, and studies are mostly focused on the North and Center-Western regions [4][5][6][7][8][9][10][11][12][13][14][15][16] .…”

Burden of tuberculosis in indigenous peoples globally: a systematic review [Review article]

“…10 In Brazil alone, there are an estimated 220 indigenous groups composed of 450 000 people, more than 60% of whom live in the Brazilian Amazon. 65 The majority of the studies from this region included in this review were from the Brazilian Amazon, 19,20,22,23,66–74 with fewer studies coming from Ecuador, Paraguay, Peru and Venezuela (Table 3; Appendix*). 18,21,24–26 No studies from the Caribbean, Mexico or Central America were found that fit the study criteria, although indigenous communities make up large parts of their populations.…”