Tuberculosis in Indigenous Communities of Antioquia, Colombia: Epidemiology and Beliefs

Abstract

Morbidity and mortality caused by tuberculosis are increased in most of the Latin-American indigenous communities. Factors that could explain this situation are poverty and limited health services access due to social conflicts and geographical isolation. We determined the frequency of tuberculosis in Colombian indigenous communities and described their knowledge related to transmission and control. We developed a descriptive study and health survey. Interviews were performed to find ancestral knowledge about tuberculosis. Sputum samples from patients with respiratory symptoms were analyzed. 10 indigenous communities were studied, which tuberculosis incidence was 291/100,000. Communities believe that tuberculosis is a body and spirit disease, which transmission is by direct contact or by witchcraft. Tuberculosis incidence in the studied communities was ninefold higher than that of the general population from Antioquia Department. Knowledge exchange could facilitate the community empowerment and implementation of educational activities which might improve the control of the disease.

Current characteristics of tuberculosis and human immunodeficiency virus co-infection in a cohort of hospitalized patients in Medellín, Colombia

“…Despite of the knowledge amassed about HIV infection, the progress in ART and a better access of patients to it worldwide, as well as the availability of rapid diagnostic and drug-susceptibility tests for TB in the last years, our results show that even in countries with moderate TB incidence like Colombia, TB is still frequently diagnosed among patients with advanced HIV-associated immunosuppression (Velásquez G, Mejía P, Restrepo N, Betancour J. Comportamiento de la tuberculosis en paciente infectados por el virus de la inmunodeficiencia (7)(8)(9)(10)(11)(12)(13)(14).…”

Cascada de atención de la tuberculosis para la población indígena en Colombia: una investigación operativa

“…En comunidades indígenas de Colombia se identificó que una dificultad para el diagnóstico y tratamiento adecuado fue la escasez de vías de comunicación y dificultades en el desplazamiento hacia las ciudades donde se ubican las IPS, debido a la falta de un sistema de transporte público eficiente (5,29). De igual manera, los profesionales de la salud que laboran en zonas rurales del Perú han reconocido el acceso limitado a las herramientas diagnósticas para la TB en los centros de atención (30).…”

“…Se estima una población de aproximadamente 370 millones de indígenas en el mundo, que representan menos de 5% de la población mundial; sin embargo, no se conoce la carga y el estado actual de la TB con precisión en Rev Panam Salud Publica 44, 2020 | www.paho.org/journal | https://doi.org/10.26633/RPSP.2020.150 los pueblos indígenas (2,3). En general, la región de América Latina tiene una carga alta de TB, que llega incluso a 1000 casos por 100 000 indígenas, en particular en comunidades de la Amazonía brasilera (3)(4)(5).…”

Health-service performance of TB treatment for indigenous and non-indigenous populations in Brazil: a cross-sectional study

“…Brazil is among the 22 countries with the highest incidence of TB, with a rate of 43 cases per 100,000 inhabitants in 2010 [1]. In the world and in Latin America, studies show a high incidence of TB in indigenous populations, exceeding that of the general population [2-7]. …”