Estado nutricional y aspectos alimentarios de mujeres indígenas del departamento de Presidente Hayes, Paraguay / Nutritional state and food aspects of indigenous women from Presidente Hayes department, Paraguay

Introducción: Las comunidades indígenas presentan un mayor riesgo de inseguridad alimentaria y malnutrición, menor disponibilidad de recursos, y una creciente dependencia de alimentos más baratos aunque con un alto grado de procesamiento. Objetivo: Identificar el estado nutricional y aspectos alimentarios en mujeres indígenas de tres comunidades del Departamento de Presidente Hayes, Chaco Paraguayo. Metodología: Estudio observacional de diseño transversal con componente analítico, que incluyó a 81 mujeres de 15 a 44 años de edad, de las etnias Maká y Toba Qom. Previo consentimiento informado, se realizó la valoración nutricional y la entrevista para obtener los datos sociodemográficos y alimentarios. Resultados: Las mujeres indígenas presentaron una frecuencia de sobrepeso de 30,8% y obesidad del 21,0%, mientras que el 1,2 % presentó desnutrición. No encontramos diferencia significativa entre las etnias, en relación al sobrepeso y obesidad, (p>0,05). Observamos que las indígenas tenían una alta ingesta de frutas, azúcares y mieles. El 87 y 88% de las mujeres indígenas de ambas etnias estudiadas refirieron no consumir lácteos y derivados y entre 65 y 69% refirieron no consumir verduras. Conclusiones: Observamos un elevado porcentaje de obesidad y sobrepeso, un bajo consumo de lácteos y verduras y un alto consumo de azúcares, relacionados posiblemente a cambios en los aspectos alimentarios y sus costumbres, influenciados por la cercanía a las zonas urbanas y el acceso a alimentos de menor precio y mayor contenido energético.

Introduction: Indigenous communities present higher risk of food insecurity and malnutrition, lower availability of resources and growing dependence on cheaper food but with high degree of processing. Objective: To identify the nutritional state and food aspects in indigenous women from three communities of Presidente Hayes Department, Paraguayan Chaco. Methodology: Cross-sectional observational study with analytical component including 81 women who were 15 to 44 years old from the Maká and Toba Qom ethnic groups. After giving their informed consent, the nutritional assessment and the interview to collect socio-demographic and food data were carried out. Results: The indigenous women presented an overweight frequency of 30.8 % and obesity of 21.0%, while malnutrition was observed in 1.2%. No significant differences were found between ethnic groups in relation to overweight and obesity (p>0.05). High ingestion of fruits, sugar and honey was observed and 87% and 88% of the indigenous women from both ethnic groups referred that they did not consume dairy products and derivatives and 65% and 69% referred that they did not consume vegetables. Conclusions: High percentages of obesity and overweight were observed. Low consumption of dairy products, its by products and vegetables and a high consumption of sugar were observed, related probably to changes in food aspects and the habits of these groups, influenced by the proximity to urban areas and the access to low prices food with high energetic content.

Distribution of human papillomavirus (HPV) genotypes and bacterial vaginosis presence in cervical samples from Paraguayan indigenous.

OBJECTIVE: To determine the frequency of human papillomavirus (HPV) types and to assess bacterial vaginosis (BV) possible associations with cervical infections in indigenous Paraguayan women of the Department of Presidente Hayes. METHODS: This study included 181 sexually active women without cervical lesions. HPV typing was performed by polymerase chain reaction with primers PGMY 09/11 followed by reverse line hybridization. BV was diagnosed by the Nugent criteria using the results from a Gram stain smear. RESULTS: Sixteen percent of women were positive for at least one high risk HPV type (HR-HPV). The most frequent genotypes were HPV 16 (4.4%), followed by HPV 58 (3.3%), HPV 45 (3.3%), HPV 53 (2.8%) and HPV 11 (2.8%). A significant association between HR-HPV and BV was observed (p=0.01). In addition, women with BV had a higher frequency of Chlamydia trachomatis (p=0.0007), Trichomonas vaginalis (p=0.00009), Mycoplasma hominis (p=0.001). CONCLUSIONS: A large variety of HPV genotypes was detected and showed a slightly different pattern from previous studies on urban women in Paraguay, with the predominance of HR-HPV. Furthermore, the information of co-infections involved in BV could be useful for the improvement of national prevention programs, as well as for laboratory surveillance of these genital infections.

Human papillomavirus and other genital infections in indigenous women from Paraguay: a cross-sectional analytical study.

BACKGROUND: The incidence of cervical cancer in Paraguay is among the highest in the world, with the human papillomavirus (HPV) being a necessary factor for cervical cancer. Knowledge about HPV infection among indigenous women is limited. This cross-sectional study analyzed the frequency of HPV and other genital infections in indigenous Paraguayan women of the Department of Presidente Hayes. METHODS: This study included 181 sexually active women without cervical lesions. They belonged to the following ethnicities: Maká (n = 40); Nivaclé (n = 23); Sanapaná (n = 33); Enxet Sur (n = 51) and Toba-Qom (n = 34). The detection of HPV and other gynecological infectious microorganisms was performed by either molecular methods (for Mycoplasma hominis, Ureaplasma urealyticum, Chlamydia trachomatis), gram staining and/or culture (for Gardnerella vaginalis, Candida sp, Trichomonas vaginalis, Neisseria gonorrhoeae), serological methods (for Treponema pallidum, human immunodeficiency virus [HIV]) or cytology (cervical inflammation). RESULTS: A high prevalence (41.4%) of women positive for at least one sexually transmitted infection (STI) was found (23.2% any-type HPV, 11.6% T pallidum, 10.5% T vaginalis, 9.9% C trachomatis and 0.6% HIV) with 12.2% having more than one STI. HPV infection was the most frequent, with 16.1% of women positive for high-risk HPV types. There was a statistically significant association observed between any-type HPV and C trachomatis (p = 0.004), which indicates that the detection of one of these agents should suggest the presence of the other. There was no association between any-type HPV and other genital infections or cervical inflammation, suggesting that other mechanism could exist to favor infection with the virus. CONCLUSION: This multidisciplinary work suggests that STIs are frequent, making it necessary to implement control measures and improve diagnosis in order to increase the number of cases detected, especially in populations with poor access to health centers.