The First National Survey of Indigenous People's Health and Nutrition in Brazil: rationale, methodology, and overview of results
The First National Survey of Indigenous People's Health and Nutrition in Brazil: rationale, methodology, and overview of results
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DOI：
10.1186/1471-2458-13-52
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发表时间：
2013-01-19
影响因子：
4.5
通讯作者：
Horta, Bernardo L.
中科院分区：
文献类型：
--
作者：
Coimbra, Carlos E. A., Jr.;Santos, Ricardo Ventura;Horta, Bernardo L.
背景资料：虽然个案研究表明，巴西土著人民的发病率和死亡率往往高于全国人口，但他们没有被系统地纳入以往的任何全国健康调查。2008-2009年进行了巴西第一次全国土著人民健康和营养调查，以获得基于全国代表性样本的基线信息，这是第一次在此报告。本文介绍了这项研究的基本原理，设计和方法，以及选定的结果。这项调查试图根据对居住在巴西村庄的土著人口进行的有代表性的概率抽样调查，确定5岁以下土著儿童和14至49岁土著妇女的营养状况和其他健康指标，根据四个主要地区（北部、东北部、中西部和南部/东南部）。通过实地访谈、临床测量和二级数据收集，研究了以下主要问题：营养状况、妇女高血压和糖尿病患病率、儿童住院率、妇女结核病和疟疾患病率、获得卫生服务和方案的机会以及家庭经济和饮食的特点。该研究获得了113个村庄（占计划样本的91.9%）、5 305个家庭（93.5%）、6 692名妇女（101.3%）和6 128名儿童（93.1%）的数据。与其他地区相比，北方的多个家庭变量遵循一种经济自主程度较高、社会经济地位较低的模式。对于非孕妇，超重（30.3%）、肥胖（15.8%）、贫血（32.7%）和高血压（13.2%）的患病率较高。在儿童中，患病率升高，观察身高为年龄赤字（25.7%），贫血（51.2%），住院治疗在前12个月（19.3%），腹泻在前一周（23.6%）。结论：土著妇女的临床流行病学参数评估点的营养过渡在巴西的所有地区的加剧发生。许多成果还反映了一种模式，即土著妇女和儿童的健康指标比记录的巴西全国人口的健康指标更差，但区域差异很大。在健康指标方面观察到的差距突出表明，巴西土著社区的基本保健和卫生服务还不如该国其他地区广泛。
Background: Although case studies indicate that indigenous peoples in Brazil often suffer from higher morbidity and mortality rates than the national population, they were not included systematically in any previous national health survey. Reported here for the first time, the First National Survey of Indigenous People's Health and Nutrition in Brazil was conducted in 2008-2009 to obtain baseline information based on a nationwide representative sample. This paper presents the study's rationale, design and methods, and selected results.Methods: The survey sought to characterize nutritional status and other health measures in indigenous children less than 5 years of age and indigenous women from 14 to 49 years of age on the basis of a survey employing a representative probabilistic sample of the indigenous population residing in villages in Brazil, according to four major regions (North, Northeast, Central-West, and South/Southeast). Interviews, clinical measurements, and secondary data collection in the field addressed the major topics: nutritional status, prevalence of hypertension and diabetes mellitus in women, child hospitalization, prevalence of tuberculosis and malaria in women, access to health services and programs, and characteristics of the domestic economy and diet.Results: The study obtained data for 113 villages (91.9% of the planned sample), 5,305 households (93.5%), 6,692 women (101.3%), and 6,128 children (93.1%). Multiple household variables followed a pattern of greater economic autonomy and lower socioeconomic status in the North as compared to other regions. For non-pregnant women, elevated prevalence rates were encountered for overweight (30.3%), obesity (15.8%), anemia (32.7%), and hypertension (13.2%). Among children, elevated prevalence rates were observed for height-for-age deficit (25.7%), anemia (51.2%), hospitalizations during the prior 12 months (19.3%), and diarrhea during the prior week (23.6%).Conclusions: The clinical-epidemiological parameters evaluated for indigenous women point to the accentuated occurrence of nutrition transition in all regions of Brazil. Many outcomes also reflected a pattern whereby indigenous women's and children's health indicators were worse than those documented for the national Brazilian population, with important regional variations. Observed disparities in health indicators underscore that basic healthcare and sanitation services are not yet as widely available in Brazil's indigenous communities as they are in the rest of the country.