Exclusive breastfeeding duration within a cohort of indigenous Terena living in the urban area of Campo Grande, Central-West Region, Brazil / Duração do aleitamento materno exclusivo em uma coorte de indígenas Terena residentes na zona urbana de Campo Grande, Região Centro-oeste do Brasil / Duración de la lactancia materna exclusiva en una cohorte de indígenas Terena que viven en el área urbana de Campo Grande, región Centro-oeste de Brasil

Abstract In Brazil, current information about breastfeeding indicators among indigenous living in the urban areas is lacking. This article describes the duration of exclusive breastfeeding and its associations with mother and child characteristics in a cohort of Terena infants. The study enrolled infants born between June 2017 to July 2018 (n = 42) and living in villages of the urban area of Campo Grande, Mato Grosso do Sul State, Brazil. Information was collected in four time-points. Variables on maternal sociodemographics and on maternal and child health characteristics were collected, respectively, during the antenatal and the first-month interviews. Variables on breastfeeding practices and bottle use were collected during the first-, six- and 12-month interviews. Associations were examined using Wilcoxon, Kruskal-Wallis, Pearson's chi-square, and Fisher's exact tests. The prevalence of exclusive breastfeeding duration to the ages of three and six months were, respectively, 50% and 11.9%. Compared to infants never introduced to bottles during the first three months of life, those bottle-fed had lower median duration of exclusive breastfeeding (15 versus 150 days) and lower prevalence of exclusive breastfeeding duration to the age of three months (22.7% versus 80%). Most Terena infants fell short of meeting the international recommended duration of exclusive breastfeeding until six months of age and suggested the negative impact of bottle use in the duration of exclusive breastfeeding.

Resumo No Brasil, não há informações atuais sobre indicadores de aleitamento materno entre indígenas residentes em áreas urbanas. O objetivo deste estudo foi descrever a duração do aleitamento materno exclusivo e suas associações com características maternas e infantis em uma coorte de lactentes Terena. O estudo incluiu crianças nascidas de junho de 2017 a julho de 2018 (n = 42) e residentes em povoados da zona urbana de Campo Grande, Mato Grosso do Sul, Brasil. As informações foram coletadas em quatro momentos. Variáveis sociodemográficas maternas e características de saúde materno-infantil foram coletadas durante o pré-natal e o primeiro mês de entrevistas, respectivamente. As variáveis sobre práticas de amamentação e uso de mamadeira foram coletadas durante as entrevistas realizadas no primeiro mês, seis meses e 12 meses. As associações foram examinadas pelos testes de Wilcoxon, Kruskal-Wallis, qui-quadrado de Pearson e exato de Fisher. As prevalências de duração do aleitamento materno exclusivo até os três e seis meses de idade foram, respectivamente, de 50% e 11,9%. Em relação aos bebês que nunca foram introduzidos à mamadeira durante os três primeiros meses de vida, aqueles que usaram mamadeira tiveram menor duração média de amamentação exclusiva (15 versus 150 dias) e menor prevalência de duração de amamentação exclusiva até os três meses de idade (22,7% versus 80%). A maioria dos lactentes Terena não atingiu a duração recomendada internacionalmente para o aleitamento materno exclusivo até os seis meses, sugerindo um impacto negativo do uso da mamadeira na duração do aleitamento materno exclusivo.

Resumen En Brasil no existe información actual sobre los indicadores de lactancia materna entre los indígenas que viven en áreas urbanas. El objetivo de este estudio fue describir la duración de la lactancia materna exclusiva y sus asociaciones con las características maternas e infantiles en una cohorte de lactantes Terena. Este estudio incluyó a niños nacidos entre junio de 2017 y julio de 2018 (n = 42) y que vivían en aldeas del área urbana de Campo Grande, Mato Grosso do Sul, Brasil. La información se recopiló en cuatro momentos. Las variables sociodemográficas maternas y las características de salud materno-infantil durante la atención prenatal y el primer mes de entrevistas, respectivamente, se recogieron para este estudio. Las variables sobre prácticas de lactancia materna y alimentación con biberón fueron recolectadas de las entrevistas realizadas en el primer mes, seis meses y 12 meses. Las asociaciones pasaron por las pruebas de Wilcoxon, de Kruskal-Wallis, el chi-cuadrado de Pearson y la prueba exacta de Fisher. La prevalencia de duración de la lactancia materna exclusiva fue del 50% hasta los tres meses de edad y del 11,9% hasta los seis meses. En comparación con los bebés que no utilizaron biberón durante los primeros tres meses de vida, los que usaron biberón tuvieron una duración promedio más corta de lactancia materna exclusiva (15 versus 150 días) y una menor prevalencia de lactancia materna exclusiva hasta los tres meses de edad (22,7% versus 80%). La mayoría de los bebés Terena no alcanzaron la duración recomendada internacionalmente para la lactancia materna exclusiva hasta los seis meses, lo que sugiere un impacto negativo de la alimentación con biberón en la duración de la lactancia materna exclusiva.

Frequency of the DI*A, DI*B and Band 3 Memphis polymorphism among distinct groups in Brazil

ABSTRACT Introduction: The Band 3 is a red blood cell protein that carries the Dia and Dib antigens from the Diego blood system. The SLC4A1 gene encodes Band 3; Band 3 Memphis is a polymorphism of normal Band 3 and has two variants, but only the variant II carries the Dia antigen. Objectives: Describe the frequencies of the DI*A and DI*B alleles and the Band 3 Memphis among blood donors, sickle cell disease (SCD) patients and Amazonian Indians. Methods: A total of 427 blood samples were collected and separated into three groups: 206 unrelated blood donors, 90 patients with SCD and 131 Amazonian Indians. We performed DI*A/B, normal Band 3 and Band 3 Memphis genotyping, using the Polymerase Chain Reaction Restriction Fragment Length Polymorphism (PCR-RFLP). Results: The frequency of the DI*A/DI*A genotype was 0.5% in blood donors and it was not found in other groups. The frequency of the DI*A/DI*B was higher in Amazonian Indians (33.6%) and the frequency of the DI*B/DI*B was highest in blood donors (92.2%). All 105 individuals tested were positive for the presence of normal Band 3 and of these individuals, only 5/105 (4.8%) presented the Band 3 Memphis mutation. Conclusion: We observed a higher frequency of the DI*B allele in blood donors and a low frequency of the DI*A/DI*A genotype in all groups studied. The Band 3 Memphis was found in a higher frequency in the blood donor group. Our findings highlight the importance of analyzing different population groups to gain a better understanding of the genetic association of blood group antigens.

Evaluation of Madras Diabetes Research Foundation-Indian Diabetes Risk Score in detecting undiagnosed diabetes in the Indian population: Results from the Indian Council of Medical Research-INdia DIABetes population-based study (INDIAB-15)

Background & objectives: Screening of individuals for early detection and identification of undiagnosed diabetes can help in reducing the burden of diabetic complications. This study aimed to evaluate the performance of Madras Diabetes Research Foundation (MDRF)-Indian Diabetes Risk Score (IDRS) to screen for undiagnosed type 2 diabetes in a large representative population in India. Methods: Data were acquired from the Indian Council of Medical Research–INdia DIABetes (ICMR–INDIAB) study, a large national survey that included both urban and rural populations from 30 states/union territories in India. Stratified multistage design was followed to obtain a sample of 113,043 individuals (94.2% response rate). MDRF-IDRS used four simple parameters, viz. age, waist circumference, family history of diabetes and physical activity to detect undiagnosed diabetes. Receiver operating characteristic (ROC) with area under the curve (AUC) was used to assess the performance of MDRF-IDRS. Results: We identified that 32.4, 52.7 and 14.9 per cent of the general population were under high-, moderate- and low-risk category of diabetes. Among the newly diagnosed individuals with diabetes [diagnosed by oral glucose tolerance test (OGTT)], 60.2, 35.9 and 3.9 per cent were identified under

Dental Prosthesis Needs and Associated Factors in Native Brazilian Kiriri Indians: a CrossSectional Study / Necessidades de Próteses Dentárias e Fatores Associados em Índios Kiriri Nativos Brasileiros: um Estudo Transversal

This study evaluated the dental prosthesis needs and associated factors in indigenous Brazilian adults from Northeastern Brazil. Dental prosthesis needs were assessed in a representative sample of 225 Indians. Edentulous area and current indication for tooth extraction according to periodontal status or non-restorable condition were registered in a clinical chart. Bivariate and logistic analyses were applied to assess associations of dental prosthesis needs and prosthesis type with age, sex, income, education, smoking, moderate or severe periodontitis, plaque index, dental caries experience, and previous dental visit. Prosthetic treatment was necessary in 83% of the participants. These individuals required 339 dental prostheses, including removable partial dentures (60.2%), fixed (33.6%), and complete dentures (6.2%). Regression analysis showed that age ≥35 years [odds ratio (OR) 5.95, 95% confidence interval (CI) 1.97­17.91, p=0.002] and caries experience ≥3 [OR 4.01, 95%CI 1.78­9.02, p=0.001] were significantly associated with prosthesis needs. The type of prosthesis required was associated with sex, age, educational level, periodontitis, caries experience, and plaque index (p≤0.03). In conclusion, the need for prosthetic rehabilitation was high in this population, and sociodemographic factors, dental plaque level, caries experience, and periodontitis were associated with the required type of prosthesis. These data can be used to plan the allocation of resources to promote preventive and curative strategies in this population.(AU)

Este estudo avaliou as necessidades de prótese dentária e fatores associados em adultos indígenas brasileiros do Nordeste do Brasil. As necessidades de prótese dentária foram avaliadas em uma amostra representativa de 225 índios. A área edêntula e a indicação para extração dental, de acordo com o estado periodontal ou condição não restaurável, foram registradas em um prontuário clínico. Análises bivariadas e logísticas foram aplicadas para avaliar as associações das necessidades de prótese dentária e tipo de prótese com idade, sexo, renda, escolaridade, tabagismo, periodontite moderada ou grave, índice de placa, experiência de cárie dentária e consulta odontológica anterior. O tratamento protético foi necessário em 83% dos participantes. Esses indivíduos necessitaram de 339 próteses dentárias, incluindo próteses parciais removíveis (60,2%), fixas (33,6%) e próteses totais (6,2%). A análise de regressão mostrou que idade ≥35 anos [odds ratio (OR) 5,95, intervalo de confiança de 95% (IC) 1,97­17,91, p=0,002] e experiência de cárie ≥3 [OR 4,01, IC 95% 1,78­9,02, p=0,001] foram significativamente associados às necessidades de prótese. O tipo de prótese necessária foi associado ao sexo, idade, escolaridade, periodontite, experiência de cárie e índice de placa (p≤0,02). Em conclusão, a necessidade de reabilitação protética foi alta nesta população e fatores sociodemográficos, nível de placa dentária, experiência de cárie e periodontite foram associados ao tipo de prótese necessária. Estes dados podem ser usados para planejar a alocação de recursos para promover estratégias preventivas e curativas nessa população.(AU)

Estimativa do risco de doenças cardiovasculares entre adultos indígenas da etnia krenak, minas gerais, brasil / Estimación de riesgo de enfermedades cardiovasculares entre adultos indígenas de la etnia krenak, minas gerais, brasil / Risk estimation of cardiovascular diseases among indigenous adults of the krenak ethnicity, minas gerais, brazil

RESUMO Objetivo: estimar o risco de doenças cardiovasculares em indígenas Krenak por meio do Escore de Risco Cardiovascular de Framingham. Metodologia: estudo epidemiológico transversal realizado com indígenas de 30 a 74 anos, em Terra Indígena localizada na região leste de Minas Gerais, Brasil. Os dados coletados foram: peso e altura para cálculo do IMC, aferição da pressão arterial e glicemia capilar casual, sexo, idade e tabagismo. O risco cardiovascular estimado em 10 anos foi calculado a partir do algoritmo de Escore de Framingham. Além disso, foram calculados o risco cardiovascular normal, o risco cardiovascular ótimo e a idade cardiovascular. A amostra foi caracterizada com a apresentação das frequências absolutas e relativas das variáveis que compõem o escore de risco cardiovascular de Framingham, estratificada pelo sexo. Resultados: observou-se que o risco cardiovascular em 10 anos entre os indígenas Krenak foi superior ao risco normal, bem como a idade cardiovascular foi maior que a idade cronológica, apesar da maioria da amostra ter apresentado um baixo risco cardiovascular em 10 anos, sem diferença estatística entre os sexos. Conclusão: apesar da predominância de baixo risco cardiovascular em 10 anos entre os indígenas Krenak, o resultado da idade cardiovascular superior à idade cronológica pode ocasionar morbimortalidade por doenças cardiovasculares ao longo do tempo nessa população.

RESUMEN Objetivo: estimar el riesgo de las enfermedades cardiovasculares a los indígenas Krenak por medio de la Puntuación de Riesgo Cardiovascular de Framingham. Metodología: estudio epidemiológico transversal realizado con indígenas de 30 a 74 años, en Tierra Indígena localizada en la región este de Minas Gerais, Brasil. Los datos recolectados fueron: peso y altura para calcular el IMC, medición de la presión arterial y glucemia capilar casual, sexo, edad y tabaquismo. El riesgo cardiovascular estimado en 10 años fue calculado a partir del algoritmo de Puntuación de Framingham. Además, se han calculado el riesgo cardiovascular normal, el riesgo cardiovascular óptimo y la edad cardiovascular. La muestra fue caracterizada con la presentación de las frecuencias absolutas y relativas de las variables que componen la puntuación de riesgo cardiovascular de Framingham, estratificada por sexo. Resultados: se observó que el riesgo cardiovascular en 10 años entre los indígenas Krenak fue superior al riesgo normal, así como la edad cardiovascular fue mayor que la edad cronológica, aunque la mayoría de la muestra presentó un bajo riesgo cardiovascular en 10 años, sin diferencia estadística entre los sexos. Conclusión: a pesar de la predominancia de bajo riesgo cardiovascular en 10 años entre los indígenas Krenak, el resultado de la edad cardiovascular superior a la edad cronológica puede ocasionar morbimortalidad por enfermedades cardiovasculares a lo largo del tiempo en esa población.

ABSTRACT Objective: to estimate the risk of cardiovascular diseases in indigenous Krenak through the Framingham Cardiovascular Risk Score. Methodology: cross-sectional epidemiological study conducted with indigenous people aged 30 to 74 years, in Indigenous Land located in the eastern region of Minas Gerais, Brazil. The data collected were: weight and height to calculate BMI, measurement of blood pressure and casual capillary blood glucose, sex, age and smoking. The cardiovascular risk estimated at 10 years was calculated from the Framingham Score algorithm. In addition, normal cardiovascular risk, optimal cardiovascular risk and cardiovascular age were calculated. The sample was characterized with the presentation of absolute and relative frequencies of the variables that make up the cardiovascular risk score of Framingham, stratified by sex. Results: it was observed that cardiovascular risk at 10 years among the Krenak indigenous was higher than normal risk, as well as cardiovascular age was higher than chronological age, although most of the sample had a low cardiovascular risk at 10 years, no statistical difference between the sexes. Conclusion: despite the predominance of low cardiovascular risk in 10 years among the Krenak indigenous, the result of cardiovascular age above chronological age can cause morbidity and mortality from cardiovascular diseases over time in this population.

Serum Gamma Glutamyltransferase (GGT) in Coronary Artery Disease: Exploring the Asian Indian Connection

Background:There is a need to identify novel markers for CAD, independent of traditional CV risk factors. One of these is gamma?glutamyl transferase (GGT), a marker of increased oxidative stress. Given the high prevalence of CAD in Asian Indians, the link of GGT and CAD in them needs to be studied. Aim: To assess GGT in patients with angiographically documented CAD. Methods and Results: Two hundred patients aged 58.1 ± 9.95 years, 73% males, hypertension 56%, diabetes 40% were included. Mean GGT was 63.6 ± 44.33 (10–269 U/L). The levels of GGT progressively increased in those with single/double or triple?vessel CAD (36.5, 61.5, and 87 U/L, respectively, P < 0.001). Using objective criteria of CAD burden (SYNTAX and Gensini scores), we reaffirmed these findings. GGT in patients with SYNTAX tertiles 0–22, 23–32, and 33 was 33, 62, and 97 U/L, respectively and in Gensini tertiles 0–17.65, 17.66–56.65, ?56.66 was 32, 52, and 88 U/L, respectively, all P < 0.001. SYNTAX score 23 was present in only 23% patients in GGT tertile 1 (<41 U/L), whereas60% and 94% in GGT tertiles 2 and 3 had SYNTAX 23. Significant positive correlation was seen between GGT and SYNTAX (r = 0.634) and Gensini score (r = 0.772). Conclusions: In this study, GGT had an independent correlation with angiographic severity of CAD and SYNTAX and Gensini scores. Although the existing evidence seems biologically plausible, more studies are needed to explore the potential role of this inexpensive marker for predicting disease burden in patients with CAD.

Seroprevalence of hepatitis B, C and D markers in indigenous patients seen at the Native American Outpatient Clinic of Universidade Federal de São Paulo

ABSTRACT Objective To detect and treat cases of viral hepatitis B, C and D in patients seen at the Native American Outpatient Clinic of Universidade Federal de São Paulo. Methods This sample comprised 81 indigenous recruited between 2018 and 2020. Volunteers were aged 7 months to 70 years (mean age of 28±20 years), belonged to 26 ethnic groups spanning the Brazilian territory and answered a questionnaire, which was attached to their medical records. Peripheral blood samples (20mL) were collected, transported to the Clinical Laboratory of Hospital Israelita Albert Einstein, processed, and tested for markers of viral hepatitis B, C and D. Results In this study, 39 (48.1%) individuals were anti-HBs (+) only, 13 (16.0%) individuals were anti-HBs (+) and anti-HBc (+), and 28 (34.6%) individuals were negative for all markers. No anti-HBc IgM+ samples were found. No cases of hepatitis C and D were found. Conclusion This analysis provided evidence of previous infection by the hepatitis B virus. These findings led to prescription of vaccination against hepatitis B to all participants who were negative for all viral hepatitis B markers, given records of prior hepatitis B vaccination were unreliable.

Caries experience in children under 5 years old in the Xingu indigenous park in Brazil

Aim: The present study sought to investigate dental caries experience and its association with sociodemographic, postnatal and breastfeeding variables in children in the agerange from 6 to 71 months of age, in the Xingu Indigenous Park, Mato Grosso, Brazil. Methods: This was an analytical cross-sectional study that used secondary data pertaining to 402 indigenous children of the Low, Middle and Eastern Xingu regions, who participated in the Oral Health Epidemiological Survey in 2013. The dependent variable was dental caries, dichotomized by the median (dmf-t≤1 and dmf-t>1). The data of independent variables were obtained by means of instruments of the Local Health Information System of the Xingu Indigenous Special Sanitary District (DSEI). Raw analyses were performed to test the association of the independent variables with the dependent variable. The variables were tested in the multiple logistic regression model. Results: The mean value of the dmf-t index was 2.60 and the prevalence of affected children was 51%. In the multiple analysis, only children older than 36 months (OR: 6.64; CI95%: 4.11 to 10.73) and those that were breastfed for a longer period of time (OR: 1.88; CI95%: 1.16 to 3.02) showed significant association with the dmf-t>1 index. Conclusion: Childhood dental caries among indigenous children was associated with age and breastfeeding prolonged for over 26 months, therefore, pointing out the need to offer dental follow-up care at earlier ages

Indicação de exodontias e fatores associados: estudo transversal na população indígena Kiriri / Recommendation of tooth extraction and associated factors: cross-sectional study in the Kiriri indigenous population

Resumo O objetivo deste artigo foi avaliar a prevalência e os fatores associados à indicação de exodontia em uma população adulta de índios Kiriri do Nordeste do Brasil. 225 indígenas (≥19 anos) foram avaliados. Os critérios de indicação de exodontia adotados foram: dentes com perda de inserção clínica ≥50%, em pelo menos 3 sítios, e, também, raízes residuais. Modelos estatísticos foram utilizados para avaliar associações entre necessidade de exodontia e as variáveis selecionadas. A porcentagem de dentes com indicação de exodontia foi de 4,98%, caracterizando uma média de 1,24 dente por indivíduo. A análise de regressão mostrou associação positiva entre indicação de exodontia e idade ≥35 anos (OR=2,24, 95%IC: 1,13-4,43, p=0,02), renda <R$ 570,00 (OR=3,34, 95%IC: 1,19-9,37, p=0,02) e índice de placa ≥40% (OR=2,38, 95%IC: 1,24-4,56, p=0,01). Uma prevalência de 33% de indivíduos com indicação de um ou mais dentes para exodontia está, principalmente, relacionada aos fatores de risco: idade maior que 35 anos, índice de placa ≥40% e renda inferior a um salário mínimo. Esse estudo reflete tanto a importância da priorização da prevenção em saúde bucal, como a necessidade de ampliação do acesso aos serviços de maior complexidade.

Abstract The scope of this cross-sectional study was to evaluate the prevalence and the associated factors of the recommendation of dental extraction in the adult Kiriri Indigenous population of northeastern Brazil. A total of 225 natives (≥19 years) were evaluated. The extraction criteria were teeth with clinical attachment loss ≥50% in at least 3 sites, and residual roots. Statistical models were used to evaluate associations between the need for dental extraction and selected variables. The percentage of teeth recommended for dental extraction was 4.98%, characterizing a mean of 1.24 tooth per individual. A regression analysis showed that age ≥35 years (OR=2.24, 95%CI: 1.13-4.43, p=0.02), income <R$ 570.00 (OR=3.34, 95%CI: 1.19-9.37, p=0.02) and plaque index ≥40% (OR=2.38, 95%CI: 1.24-4.56, p=0,01) were significantly associated with indication for dental extraction. A prevalence of 33% of subjects with dental extraction recommendation were associated with age older than 35 years, plaque index ≥40% and income less than a minimum wage were related with the recommendation for extraction. This study reflects the importance of prioritizing oral health prevention, as well as the need to expand complex dental services.

Diversidade alimentar de crianças indígenas de dois municípios da Amazônia Ocidental brasileira / Food diversity among indigenous children from two municipalities of the Brazilian Western Amazon

Resumo Objetivou-se explorar a prática alimentar das crianças indígenas de zero a dois anos, residentes nos municípios de Cruzeiro do Sul e Mâncio Lima no Acre. Realizou-se estudo transversal com crianças indígenas das etnias Katukina (Cruzeiro do Sul), Nukini, Nawa e Poyanawa (Mâncio Lima) em outubro de 2013. Utilizou-se um questionário estruturado sobre o consumo alimentar do dia anterior à coleta, baseado nos indicadores alimentares propostos pelo Ministério da Saúde. Estudou-se 94 crianças (50% da etnia Katukina, 27% Poyanawa, 13% Nukini e 10% da Nawa). As crianças menores de 6 meses de idade, apesar da maioria receber leite materno, 42,1% delas consumiam água, 15,8% comida de sal e 11,1% preparados típicos da região. Nas faixas de idade de 6 a 12 meses e 13 a 23 meses identificou-se um alto consumo de alimentos ultraprocessados (52,6% e 28,6% respectivamente) enquanto que o consumo de alimentos complementares relevou-se insuficiente (33% de frutas e 25% de comida de sal na faixa de 6 a 13 meses e 41,2% de frutas e 19,6% de comida de sal na faixa de 13 a 23 meses). O perfil alimentar das crianças indígenas mostrou-se inadequado para a idade, refletindo uma situação preocupante na saúde infantil desta população.

Abstract Our aim was to explore the feeding practices of indigenous children younger than two years old, living in Cruzeiro do Sul and Mâncio Lima, in Acre, Brazil. A cross-sectional study was conducted with indigenous children of the Katukina (Cruzeiro do Sul), Nukini, Nawa and Poyanawa (Mâncio Lima) ethnicities in October 2013. We used a structured questionnaire on the food consumption of the day before the collection, based on the food indicators proposed by the Ministry of Health. A total of 94 children (50% Katukina, 27% Poyanawa, 13% Nukini, and 10% Nawa) were studied. Among children under 6 months of age, although the majority was breastfed, 42.1% drank water, 15.8%, savory food, and 11.1%, local cuisine. In the age groups of 6 to 12 months and 13 to 23 months, a high consumption of ultra-processed foods was identified (52.6% and 28.6% respectively), while the consumption of complementary food was insufficient (33% of fruits and 25% of savory food between 6 and 13 months, and 41.2% of fruits and 19.6% of savory food between 13 and 23 months). The feeding profile of these indigenous children was inadequate for their age, revealing a concerning situation for this population.

Evaluación de variables cardiovasculares en una población calchaquí de media y alta montaña de Tucumán / Evaluation of Cardiovascular Variables in a Calchaquí Population in the Middle and High Mountains of Tucumán

RESUMEN Introducción: La comunidad Quilmes (Tucumán) abarca 2400 habitantes de media y alta montaña (1800 a 4000 metros sobre el nivel del mar). El objetivo del presente trabajo fue conocer su estado de salud cardiovascular. Material y métodos: Se efectuó una investigación cuantitativa descriptiva transversal en personas pertenecientes a dicha comunidad que asistieron voluntariamente en los días 27 a 29 de septiembre de 2018 a la evaluación prevista. Resultados: Se estudiaron 202 pobladores (125 mujeres y 77 varones; 48 ± 1,4 años). El 23% de ellos tenían hipertensión arterial (HTA); un 14% eran tabaquistas; el 4,9% tenían diabetes (DBT); el 18% presentaba dislipidemia (DLP); el 25% consumía alcohol rutinariamente (1,0 ± 0,4 L/día). Asimismo, el 29% presentaba sobrepeso y el 36% obesidad. Se registró presión arterial (PA) elevada en 48 personas al momento del estudio. La PA disminuyó en la tercera toma con respecto a la primera, pero la frecuencia cardíaca aumentó en la tercera toma (74 ± 1 latidos por minuto vs. 77 ± 1; p <0,01). La saturación de O2 (95,0 ± 0,2%) se correlacionó negativamente con la edad (Pearson r: −0,266; p <0,001). En los pobladores con PA normal, la relación E/A determinada ecográficamente fue mayor (1,2 ± 0,0) y el espesor de la pared posterior del ventrículo izquierdo fue menor (8,5 ± 0.5 mm) que en aquellos con PA elevada (0,92 ± 0,1 y 9,0 ± 0.3, respectivamente, p <0,001). El 24% presentó placas ateroscleróticas y 120 pobladores presentaron DLP. Conclusiones: La población Quilmes presenta una prevalencia de factores de riesgo cardiovascular similar a la de centros urbanos, los que podrían llevar en los próximos años a un incremento de la morbimortalidad cardiovascular en esta población

ABSTRACT Background: The Quilmes community includes 2,400 inhabitants of the middle and high mountains of Tucumán (1,800 to 4,000 meters above sea level). The purpose of the present study was to know their cardiovascular health status. Material and methods: A cross-sectional descriptive quantitative investigation was carried out in people belonging to the Quilmes community who voluntarily attended the planned evaluation on September 27-29, 2018. Results: Two hundred and two settlers were studied (125 women and 77 men; 48 ± 1.4 years), 23% of them had hypertension (HTN); 14% were smokers; 4.9% had diabetes; 18% had dyslipidemia (DLP) and 25% usually consumed alcohol (1.0 ± 0.4 L/day). Also, 29% were overweight and 36% obese. High blood pressure (BP) was recorded in 48 individuals at the time of the study. Blood pressure decreased in the third compared to the first measurement, whereas heart rate increased in the third assessment (74 ± 1 beats per minute vs. 77 ± 1; p <0.01). Oxygen saturation (95.0 ± 0.2%) was negatively correlated with age (Pearson r: −0.266; p <0.001). In individuals with normal BP, ultrasound E/ratio was higher (1.2 ± 0.0) and left ventricular posterior wall thickness was lower (8.5±0.5 mm) than in those with elevated BP (0.92±0.1 and 9.0 ± 0.3, respectively, p <0.001). Twenty-four percent of individuals had atherosclerotic plaques and 120 had DLP. Conclusions: The Quilmes population presents a prevalence of cardiovascular risk factors similar to that of urban centers, which could lead to an increase in cardiovascular morbidity and mortality in the coming years

Allelic Diversity of the Hemochromatosis Gene (HFE) in Malays, Chinese and Indians

@#Introduction: Hereditary hemochromatosis (HH) is an autosomal recessive disorder that causes accumulation of iron in circulating blood and organs. The disease is associated with H63D, S65C and C282Y variants of the haemochromatosis (HFE) gene and, if not treated can cause organ damage and may prove fatal. The main objectives of the present survey were to screen these genetic variants and establish risk profiles for developing HH in Malays, Chinese and Indians. Methods: A total of two hundred and twenty-two unrelated and healthy individuals together representing Malay, Chinese and Indian ethnicities in Malaysia were scored for the H63D, S65C and C282Y variants using a polymerase chain reaction-restriction fragment length polymorphism technique. Results: There are clear differences in H63D, S65C and C282Y allele and genotype frequency distributions between Malays, Chinese and Indians. In particular, H63D is more common in Chinese (5.19%) and Indians (7.29%), while S65C is more common in Malays (1.03%) and Chinese (1.04%). In addition, a susceptibility genotype for HH (the compound heterozygote for C282Y and H63D) was only detected in Indians (0.02%). Conclusion: Overall, our study is the first to provide data on the prevalence of H63D, S65C, and C282Y genetic variants and HH risk profiles for Malays, Chinese and Indians.

Birth weight of indigenous children in Brazil: results of the First National Survey of Indigenous People's Health and Nutrition / Peso ao nascer de crianças indígenas no Brasil: resultados do Primeiro Inquérito Nacional de Saúde e Nutrição dos Povos Indígenas / Peso al nacer de niños indígenas en Brasil: resultados de la Primera Encuesta Nacional sobre la Salud y Nutrición de los Pueblos Indígenas

Birth weight is an important predictor of perinatal, infant, and preschool-age children morbimortality. However, information about indigenous children's birth weight is still scarce. This study aimed to analyze the birth weight of indigenous children based on data from the First National Survey of Indigenous People's Health and Nutrition, Brazil (2008-2009). This is the first study to address indigenous children's birth weight based on a nationwide representative sample. Mean birth weights and the respective standard deviations were calculated according to geopolitical region, sex, type of birth, and birthplace. The chi-square test was used to analyze differences in proportions, and Kruskal-Wallis and Mann-Whitney U tests in means, considering sample design and data normality. We found no records on birth weight in the researched documents for 26.7% of the 6,128 sampled children. The mean birth weight for the 3,994 children included in the analyses was 3,201g (standard deviation - SD ± 18.6g), regardless of sex, type of birth, and birthplace. The prevalence of low birth weight was 7.6% (n = 302) and was significantly higher among girls. Boys presented significantly higher mean birth weight than girls, regardless of the geopolitical region. Low birth weight was slightly less frequent among indigenous children when compared to Brazilian children in general. Our study indicates the need to improve prenatal care and the quality of consultation records for indigenous women as a strategy to promote safe pregnancy and childbirth.

O peso ao nascer é um importante preditor de morbimortalidade perinatal, infantil e pré-escolar. São escassas as informações sobre o peso ao nascer das crianças indígenas no Brasil. O estudo teve como objetivo analisar o peso ao nascer das crianças indígenas, com base nos dados do Primeiro Inquérito Nacional de Saúde e Nutrição dos Povos Indígenas, Brasil (2008-2009). Este é o primeiro estudo a avaliar o peso ao nascer de crianças indígenas com base em uma amostra nacional representativa. Foram calculadas as médias e desvios-padrão de acordo com macrorregião, sexo, tipo e parto e local do parto. Foram utilizados o teste de qui-quadrado para analisar as diferenças de proporções e os testes de Kruskal-Wallis e U de Mann-Whitney para diferenças nas médias, considerando o desenho amostral do estudo e a normalidade dos dados. Para 26,7% das 6.128 crianças da amostra, não foi possível localizar qualquer registro de peso ao nascer nos documentos consultados. Entre as 3.994 crianças incluídas nas análises, o peso médio ao nascer, independentemente de sexo, tipo de parto e local do parto, foi 3.201g (desvio padrão - DP ± 18,6g). A prevalência de baixo peso ao nascer foi 7,6% (n = 302), significativamente mais alta em meninas. Os meninos apresentaram peso médio ao nascer significativamente mais alto que as meninas, independentemente de região. A frequência de baixo peso ao nascer foi ligeiramente mais baixa que nas crianças brasileiras em geral. O estudo aponta para a necessidade de melhorar a assistência pré-natal e a qualidade dos registros das consultas das mulheres indígenas, como estratégia para promover a segurança na gravidez e no parto.

El peso al nacer es un predictor importante de morbimortalidad perinatal, infantil y preescolar. La información sobre el peso al nacer de niños indígenas es escasa. El objetivo de este estudio fue analizar el peso al nacer de los niños indígenas, basado en datos de la Primera Encuesta Nacional de Salud y Nutrición de los Pueblo Indígenas, Brasil (2008-2009). Se trata del primer estudio dirigido al peso al nacer de niños indígenas, basado en una muestra representativa nacionalmente. Las medias y las respectivas desviaciones estándar del peso al nacer se calcularon según la región geopolítica, sexo, tipo de nacimiento y localización del mismo. Se usó un test chi-cuadrado para analizar las diferencias en proporciones y las pruebas Kruskal-Wallis y de la U de Mann-Whitney para las diferencias en las medias, considerando el diseño de la muestra del estudio y normalidad de los datos. Para un 26,7% de los 6.128 niños incluidos en la muestra no fue posible localizar ningún registro de peso al nacer en los documentos investigados. De los 3.994 niños incluidos en el análisis, la media de peso al nacer, independiente del sexo, tipo de nacimiento, y lugar de nacimiento, fue 3.201g (desviación estándar - SD ± 18,6g). La prevalencia del bajo peso al nacer fue 7,6% (n = 302) y fue significativamente más alta entre niñas. Los niños presentaron significativamente una media más alta de peso al nacer que las niñas, independientemente de la región. La frecuencia del bajo peso al nacer fue ligeramente más baja que la observada en niños brasileños en general. Este estudio presenta aspectos que se necesitan mejorar en el cuidado prenatal y en la calidad de los registros de las consultas de mujeres indígenas, como una estrategia para promover un embarazo y parto seguros.

Serological markers of hepatitis B virus in indigenous populations from Amazonas state, Venezuela / Marcadores serológicos del virus de hepatitis b en pueblos indígenas del estado amazonas, venezuela

RESUMEN Venezuela presenta un nivel de prevalencia intermedia de Hepatitis B, con cuatro focos de alta endemicidad asociados principalmente a población indígena. Las prevalencias halladas en el Amazonas venezolano tienen distintas distribuciones entre los pueblos, observándose diferentes particularidades epidemiológicas. El objetivo del presente trabajo fue reportar la prevalencia de VHB en población indígena de diferentes pueblos y regiones geográficas del estado Amazonas, que no habían sido evaluados hasta la fecha, mediante la determinación de los marcadores serológicos: Antígeno de Superfìcie del Virus de Hepatitis B (AgsHB) y Anticuerpos Anticore (Anti-HBc). Se estudiaron 1390 individuos de 15 pueblos indígenas (Baniva, Baré, Curripaco, Jivi, Mapoyo, Maco, Piapoco, Piaroa, Puinave, Sáliba, Warekena, Yabarana, Yanomami, Yekuana, Yeral), resultando una prevalencia de exposición al Virus de 37,6 % (Anti-HBc), y una prevalencia de infección activa de 5,6 % (AgsHB). La prevalencia de exposición al virus es proporcional a la edad. No se encontró diferencia significativa en relación al sexo. La exposición al virus en el pueblo Sáliba fue significativamente menor al resto de los pueblos indígenas (p<0,001), y la observada en Yabarana, significativamente mayor (p<0,001). Se encontró una prevalencia de AgsHB significativamente mayor (p<0,01) en el pueblo indígena Yabarana. Se puede predecir que existe relación entre prevalencia de exposición al virus de hepatitis B y la distancia geográfica al centro urbano.

ABSTRACT Venezuela has a level of intermediate prevalence of Hepatitis B, with four foci of high endemicity associated mainly to indigenous population. The prevalence found in the Venezuelan Amazon have different distributions among the peoples, observing different epidemiological particularities. The aim of this study was to report the prevalence of Hepatitis B in the indigenous population of different geographical regions of the Amazonas State that have not yet been evaluated, by determining serological markers: HBV surface antigen (HBsAg) and HBV core antibody (Anti-HBc). Blood samples were tested from 1390 individuals from 15 indigenous populations (Baniva, Baré, Curripaco, Jivi, Mapoyo, Maco, Piapoco, Piaroa, Puinave, Sáliba, Warekena, Yabarana, Yanomami, Yekuana, Yeral. Prevalence of exposure to the virus (Anti-HBc) was 37.6 % and the prevalence of active infection (HBsAg) was 5.6 %. Prevalence of exposure to the virus was directly proportional to age. No significant difference was found in relation to sex. A significant difference was found in Sáliba people who show prevalences significantly smaller than the rest of the indigenous peoples (p<0.001), while the observed in Yabarana was significantly higher (p<0.001). A significantly higher prevalence of HBsAg was found in Yabarana people (p<0.001). It can be predicted that there is a relationship between prevalence of exposure to hepatitis B virus and geographic distance to urban centers.

Parasitological and molecular diagnosis of cutaneous leishmaniasis among indigenous peoples in the state of Roraima, Brazil

Abstract INTRODUCTION: We diagnose cases of cutaneous leishmaniasis (CL) among indigenous peoples of the state of Roraima, Brazil, and discuss some aspects of its epidemiology. METHODS: Skin imprints, and lesion exudate samples collected on filter paper were examined using parasitological and molecular techniques, respectively. RESULTS: Of 30 indigenous individuals, representing several ethnic groups, with suspected cases of CL, 27 (90%) tested positive for Leishmania spp. by PCR, and 21 (70%) by parasitological microscopy. CONCLUSIONS: Cutaneous leishmaniasis is indistinctly present among indigenous peoples from different regions of the state of Roraima. Individuals from seven of the ten existing ethnic groups in the state tested positive for CL, demonstrating the need for further investigation of the disease among these ethnic groups.

Antes sós do que mal acompanhados: contato e contágio com povos indígenas isolados e de recente contato no Brasil e desafios para sua proteção e assistência à saúde / Better alone than in bad company: contact and contagion with isolated and recently contacted indigenous people in Brazil and challenges for their protection and health care

Resumo O objetivo deste artigo é apresentar e discutir a vulnerabilidade de povos indígenas em isolamento voluntário a epidemias decorrentes do contato com representantes de nossa sociedade e apontar os desafios para a assistência à saúde nas situações de contato iminente. A partir da experiência dos autores na atenção à saúde de comunidades indígenas isoladas e de contato recente e de informações existentes na literatura indigenista, são apresentados exemplos da alta mortalidade que incidiu sobre alguns povos indígenas em períodos posteriores à quebra de seu estado de isolamento. O artigo atualiza as informações existentes sobre povos indígenas isolados no Brasil, discute a política indigenista e as ameaças a que estão submetidos esses povos pelo avanço da invasão ilegal de seus territórios e alerta para a possibilidade de novos contatos entre esses grupos e a sociedade circundante no contexto atual de ataque aos direitos indígenas agravados pela epidemia de covid-19. Contextualizam-se a suscetibilidade dos povos indígenas isolados, a necessidade de preparação para futuras situações de contato e medidas para evitar o contágio quando ocorrer a quebra do estado de isolamento desses povos.

Abstract The purpose of this article is to present and discuss the vulnerability of indigenous people in voluntary isolation due to epidemics resulting from contact with representatives of our society and to point out the challenges for health care in situations of imminent contact. Based on the authors' experience in the health care of isolated and recently contacted indigenous communities and on information in the indigenous literature, examples of the high mortality that affected some indigenous peoples in periods after break of their isolation state are presented. The article updates the existing information on isolated indigenous peoples in Brazil, discusses the indigenous policy formulated for them, the threats to which they are subjected by the advance of the illegal invasion of their territories and alerts to the possibility of new contacts of these groups and the surrounding society, in current context of attack on indigenous rights aggravated by the COVID-19 pandemic. It contextualizes the susceptibility of isolated indigenous peoples, the need to be ready for future situations of contact and measures to avoid contagion when the isolation of these peoples is interrupted.

Prevalência estimada e fatores associados à hipertensão arterial em indígenas adultos Krenak do Estado de Minas Gerais, Brasil / Estimated prevalence of hypertension and associated factors in Krenak indigenous adults in the state of Minas Gerais, Brazil / Prevalencia estimada y factores asociados a la hipertensión arterial en indígenas adultos Krenak del Estado de Minas Gerais, Brasil

Estudo transversal realizado em 2016, cujo objetivo foi descrever a prevalência estimada e os fatores associados à hipertensão arterial sistêmica entre adultos e idosos Krenak, em Terra Indígena localizada na beira do rio Doce, na região leste de Minas Gerais, Brasil. Foram aferidos peso, estatura, perímetro da cintura, pressão arterial sistólica, pressão arterial diastólica e glicemia capilar. Informações sociodemográficas e de estilo de vida foram obtidas via aplicação de questionário face a face. Modelos de regressão de Poisson foram construídos para estimar a associação independente entre as variáveis de interesse e a hipertensão arterial sistêmica. A prevalência da hipertensão arterial sistêmica foi de 31,2% (IC95%: 24,4-37,9) entre os indígenas Krenak. Houve associação independente no modelo final para o aumento da idade, obesidade abdominal e hiperglicemia. Destaca-se a necessidade de ações eficazes de prevenção, de diagnóstico e acompanhamento frente aos fatores modificáveis da hipertensão arterial sistêmica, uma vez que foi observada elevada prevalência dessa condição na comunidade indígena Krenak.

This cross-sectional study in 2016 aimed to describe the estimated prevalence of systemic arterial hypertension and associated factors in Krenak adults and elderly in an indigenous community located along the Rio Doce in eastern Minas Gerais state, Brazil. We measured weight, height, waist circumference, systolic blood pressure, diastolic blood pressure, and capillary blood glucose. Sociodemographic and lifestyle information was obtained from a face-to-face questionnaire. Poisson regression models were constructed to estimate independent associations between the target variables and hypertension. Prevalence of hypertension was 31.2% (95%CI: 24.4-37.9) in Krenak indigenous. The final model showed an independent association with increasing age, abdominal obesity, and hyperglycemia. The results highlight the need for effective measures in prevention, diagnosis, and follow-up of modifiable risk factors for hypertension, since high prevalence of this condition was observed in the Krenak indigenous community.

Estudio transversal realizado en 2016, cuyo objetivo fue describir la prevalencia estimada y los factores asociados a la hipertensión arterial sistémica entre adultos y ancianos Krenak, en Terra Indígena localizada en la ribera del río Doce, en la región este de Minas Gerais, Brasil. Se midieron peso, estatura, perímetro de la cintura, presión arterial sistólica, presión arterial diastólica y glucemia capilar. Informaciones sociodemográficas y de estilo de vida se obtuvieron vía la aplicación de un cuestionario cara-a-cara. Modelos de regresión de Poisson se construyeron para estimar la asociación independiente entre las variables de interés y la hipertensión arterial sistémica. La prevalencia de la hipertensión arterial sistémica fue de 31,2% (IC95%: 24,4-37,9) entre los indígenas Krenak. Hubo asociación independiente en el modelo final para el aumento de edad, obesidad abdominal e hiperglicemia. Se destaca la necesidad de acciones eficaces de prevención, de diagnóstico y acompañamiento frente a los factores modificables de la hipertensión arterial sistémica, ya que se observó una elevada prevalencia de esa condición en la comunidad indígena Krenak.

Sobre crise: significados e perspectivas. Entrevista com Marco Américo Lucchesi / On the crisis: meanings and perspectives. Interview with Marco Américo Lucchesi

Resumo Na entrevista, Marco Américo Lucchesi, professor Titular de Literatura Comparada da Universidade Federal do Rio de Janeiro (UFRJ), professor convidado da Fundação Oswaldo Cruz (Fiocruz), membro e presidente da Academia Brasileira de Letras, apresenta sua percepção da crise atual e do impacto sobre a consolidação da democracia brasileira. Com base em suas experiências como intelectual crítico e atuante, comenta os ataques que assistimos, no Brasil, à cultura e à produção de conhecimento. Ao mesmo tempo, lembra que nenhuma democracia se configura como uma realidade ontológica terminada e ressalta o papel das escolas e universidades na mobilização da cidadania e na difusão de valores republicanos. Frente à constatação de que vivemos uma profunda mudança de registro cultural, aponta algumas conquistas que se expressam, por exemplo, pela presença de índios e negros nas universidades. Reconhecendo o pedido de socorro imerso em todas as crises,convoca-nos a reavivar o sonho e a coragem, combustíveis da utopia, e defende a suspensão das distinções em favor da formação de uma frente democrática e solidária. São análises e convocações que se pautam, o tempo todo, numa firme confiança na potência e na capacidade de resistência da cultura.

Abstract In this interview, Marco Américo Lucchesi, Tenured Professor of Comparative Literature at the Federal University of Rio de Janeiro (UFRJ), visiting professor of the Oswaldo Cruz Foundation (Fiocruz), and member and president of the Brazilian Academy of Letters, outlines his perception of the current crisis and the impact on the consolidation of Brazilian democracy. Based on his experiences as a critic and intellectual, he comments on the attacks on culture and the production of knowledge that we have witnessed in Brazil. He reminds us that no democracy is a fully-fledged ontological reality and highlights the role of schools and universities in mobilizing citizenship and spreading republican values. He highlights some achievements that are expressed by the presence of Indians and African Brazilians in universities. Acknowledging the call for help inherent in every crisis, he calls upon us to revive the dream and courage and advocates the suspension of distinctions in favor of forming a front of democracy and solidarity. These are analyses and convocations that are based, at all times, on a firm confidence in the power and capacity of resilience of culture.

O povo indígena tupinikim no contexto do desastre ambiental no rio doce / Indians tupinikim in the context of environmental disaster at rio doce river / Los pueblos indígenas y el contexto dedesastre en el rio doce / Les tupinikim indiens sur la désastre environnemental en contexte rio doce

O texto é parte de uma etnografia sobre o Desastre no Rio Doce e seus impactos nos povos Tupinikim no município de Aracruz estado do Espírito Santo. Descreve-se a organização dos pleitos indígenas por indenização, a formação de coalizões e segmentações a partir dos conflitos gerados no contexto do Desastre. A partir de categorias empregadas pelos Tupinikim para tornar inteligíveis sua afetação, discute-se como ocorrem as interações e os regimes de apropriação do desastre e suas consequências para a organização social desse povo.

The text is an ethnography about the Rio Doce Environmental Disaster and its impacts on the Indians Tupinikim that live in the municipality of Aracruz, state of Espírito Santo. The aims is to describe the organization of indigenous claims by indemnity, the formation of coalitions and segmentation from the conflicts generated in the context of the Disaster. From categories used by the Tupinikim to make their affectation intelligible, we discuss how interactions and regimes of disaster appropriation occur and consequences for their social organization.

El texto es parte de una etnografía sobre el desastre del Río Doce y sus impactos en los pueblos indígenas Tupinikim en el municipio de Aracruz, estado de Espírito Santo. Se describe la organización de reclamos indígenas por indemnización, la formación de coaliciones y la segmentación de los conflictos generados en el contexto del Desastre. A partir de las categorías utilizadas por los Tupinikim para hacer que su afectación sea inteligible, discutimos cómo ocurren las interacciones y los regímenes de apropiación del desastre y sus consecuencias para su organización social.

Le texte fait partie d'une ethnographie sur la Désastre environnemental dans Rio Doce et ses impacts sur les indiens Tupinikim de la municipalité d'Aracruz, dans l'État d'Espírito Santo. L'organisation des revendications indiens par indemnisation, la formation de coalitions et la segmentation des conflits générés dans le contexte de la catastrophe constituer le centre de l'analyse. Basé sur les catégories utilisées par les Tupinikim pour rendre leur affectations intelligible, nous discutons de la manière dont les interactions et les régimes d'appropriation du Désastre se produisent et leurs conséquences pour l'organisation sociale de ces indiens.

Antibioticoterapia em crianças indígenas e não indígenas desnutridas / Antibiotic therapy in indigenous and non-indigenous undernourished children

INTRODUÇÃO: A prevalência da desnutrição infantil vem diminuindo em todo o mundo, mas ainda acomete milhões de crianças, especialmente indígenas. Devido ao elevado número de doenças infecciosas associadas à desnutrição, a antibioticoterapia faz parte da terapêutica recomendada. OBJETIVO: Observar os casos de desnutrição entre crianças indígenas e não indígenas hospitalizadas e a terapêutica empregada durante o tratamento. MÉTODOS: Estudo de coorte retrospectivo, farmacoepidemiológico, realizado com informações extraídas de prontuários arquivados do período de janeiro de 2012 a dezembro de 2014 de um hospital público. RESULTADOS: Participaram 166 crianças, sendo o número de crianças indígenas aproximadamente seis vezes maior do que não indígenas. Houve maior prevalência entre lactentes e crianças com idade inferior a um ano apresentaram mais chances de serem internadas por desnutrição. Os diagnósticos de desnutrição mais vistos foram os inespecíficos, com uma proporção significativa de óbitos relacionados ao diagnóstico E43. As infecções mais comuns foram do sistema digestório e respiratório. Crianças indígenas tiveram quase cinco vezes mais chances de apresentarem infecção respiratória. A maior proporção recebeu até três antibióticos, havendo crianças que receberam mais que sete antibióticos diferentes durante o período de internação. CONCLUSÃO: A população infantil deve ser acompanhada por meio de inquéritos que possam subsidiar políticas de saúde que atendam suas necessidades. É necessária a capacitação dos profissionais envolvidos no cuidado da criança desnutrida, recursos materiais e financeiros, a fim diminuir o número de diagnósticos inespecíficos e evitar o uso indiscriminado de antibióticos, sendo imprescindível uma política de controle efetiva no uso da politerapia antimicrobiana.

INTRODUCTION: The prevalence of child malnutrition is declining worldwide, but still affects millions of children, especially indigenous people. Due to the high number of infectious diseases associated with malnutrition, antibiotic therapy is part of the recommended therapy. OBJECTIVE: To observe the cases of malnutrition among hospitalized indigenous and non-indigenous children and the therapy used during treatment. METHODS: Retrospective cohort study, pharmacoepidemiological, carried out with information extracted from medical records filed from January 2012 to December 2014 of a public hospital. RESULTS: 166 children participated, with the number of indigenous children being approximately six times higher than that of nonindigenous children. There was a higher prevalence among infants and children under one year of age who were more likely to be hospitalized for malnutrition. The most frequent diagnoses of malnutrition were nonspecific, with a significant proportion of deaths related to diagnosis E43. The most common infections were of the digestive and respiratory system. Indigenous children were almost five times more likely to have respiratory infection. The highest proportion received up to three antibiotics, with children receiving more than seven different antibiotics during the hospitalization period. CONCLUSION: The child population must be accompanied by surveys that can subsidize health policies that meet their needs. It is necessary to train the professionals involved in the care of malnourished children, material and financial resources, in order to reduce the number of non-specific diagnoses and to avoid the indiscriminate use of antibiotics, a policy of effective control in the use of antimicrobial polytherapy is essential.