Cardiovascular risk factors among Brazilian Karib indigenous peoples: Upper Xingu, Central Brazil, 2000-3.

BACKGROUND: Brazil has more than 200 indigenous peoples with 170 different languages that result in different epidemiological and demographic situations. The objective of this study was to describe the nutritional and metabolic profile of the adult Karib indigenous peoples, inhabitants of the Upper Xingu region, as well as to evaluate their possible effects on their cardiovascular health. METHODS: In 2002, the Karib population comprised 1091 individuals, 390 of whom (35.7%) were 20 years of age or older. This study was based on results from 251 adult individuals (64.4%). chi(2) statistics were used to evaluate the possible relationship between chronic diseases and tribe, gender and age. Analysis of variance was used to compare the average values of the biomedical variables of the individuals according to tribe and gender. RESULTS: The prevalence of the main risk factors detected was: 39.3% overweight and 6.8% obese, mainly among men (60.4%), 41.8% for central obesity mainly among women (66.7%), 68% for dyslipidaemia and 15.4% for blood pressure alterations mainly among men (24.7%). Overall, percentages were higher than in the non-indigenous Brazilian population. The percentage of individuals presenting simultaneously with at least two cardiovascular risk factors (29%) was also remarkable. CONCLUSIONS: These findings emphasize the need to implement preventive health measures to control obesity and other cardiovascular risk factors in indigenous peoples.

[Health and disease among Panará (Kreen-Akarôre) Indians in Central Brazil after twenty-five years of contact with our world, with an emphasis on tuberculosis]. / Saúde e doença em índios Panará (Kreen-Akarôre) após vinte e cinco anos de contato com o nosso mundo, com ênfase na ocorrência de tuberculose (Brasil Central).

The Panará, who had previously lived in isolation from Brazilian national society in the Amazon forest, were first contacted in 1973. Two years later they were moved to another area in Central Brazil. During this same period they were reduced to 82 members, the survivors of a population of 400 to 500 in the mid-1960s. In 1995 they returned to a small area in their old territory still not occupied by outsiders. There, three years later, a health survey showed a presumed diagnosis of tuberculosis in 15 individuals out of a population of 181. Further tests in the town of Colider, based on clinical data and chest X-rays, confirmed the diagnosis in 10 Panará (6 children under 10 years of age and 4 adults from 40 to 50 years old). BCG scars were present in the entire population. The nutritional status of Panará children was better than that of other indigenous groups in the Amazon region. The following measures were introduced for Tb control: a) treatment follow-up in the village, under direct supervision by both a nurse and the local indigenous health worker; b) compliance with defined criteria for ending treatment; c) periodic control of contacts and non-contacts; c) and establishment of a reference system with the health services in Colider.

[Diabetes as primary or associated cause of death in the state of São Paulo, Brazil, 1992]. / Diabetes como causa básica ou associada de morte no estado de São Paulo, Brazil, 1992.

INTRODUCTION: Analysis of mortality data are usually performed with reference to the underlying cause of death. The importance of diabetes as a cause of death is always underestimated, because diabetics generally die from chronic complications of the disease, these being considered as the underlying cause of the death. To attenuate this problem, mortality data should be analyzed on the basis of all the causes listed on the death certificate. Frequency of references to diabetes on death certificates and the principal associated causes were evaluated as a contribution to the solution of this problem. METHODOLOGY: Specific death rates and proportional mortality by diabetes, as underlying or associated cause, were calculated on the basis of information derived from death certificates by the ACME program (Automated Classification of Medical Entities), for the State of S. Paulo, in 1992. RESULTS AND CONCLUSIONS: Of a total of 202,141 deaths, diabetes was mentioned in 13,786 (6.8%) and as being the underlying cause in 5,305(2.6%). The proportion was higher for women than men (10.1 vs. 4.6% as mentioned, and 6.1 vs 2.9% as underlying cause). Among deaths with a mention of diabetes on the certificate, the main underlying causes were: diabetes (38.5%), cardiovascular (37.2%) and respiratory (8.5%) diseases, and neoplasias (4.8%). When diabetes was the underlying cause, the main associated causes were: cardiovascular (42.2%), respiratory (10.7%) and genitourinary (10.1%) diseases. When diabetes was an associated cause, the main underlying causes were: cardiovascular (60.5%) and respiratory (13.8%) diseases, and neoplasias (7.9%). In spite of the limitation of the data from death certificates, it is possible to observe the importance of diabetes as cause of death, reflecting its magnitude as a health problem. Also, the analysis by multiple causes of deaths gives an idea of the morbidity profile associated with diabetes at the time of death, showing the importance of the group of cardiovascular diseases.

[Self-reported diabetes mellitus in the city of São Paulo: prevalence and inequality] / Diabetes mellitus auto-referido no Município de São Paulo: prevalência e desigualdade.

This report analyzes characteristics of self-reported diabetes mellitus in the city of São Paulo, Brazil. The data were obtained from the Brazilian Multicenter Study on Prevalence of Diabetes Mellitus, a household survey performed in 1986-88. The São Paulo sample consisted of 2,007 individuals aged 30-69 years, of both sexes, selected from three areas with distinct socio-economic levels. The estimated prevalence using a 75g glucose load and measurement of two-hour capillary glycemia was 9.7%. Prevalence of self-reported diabetes was 4.7% and increased with age and presence of family history of diabetes. There was a significant difference between sexes (3.5% in men and 5.7% in women), with higher rates of self-reported diabetes at higher economic levels among men and higher rates at lower socio-economic levels among women.