Hilton P. Silva

Identification of Polynesian mtDNA haplogroups in remains of Botocudo Amerindians from Brazil

There is a consensus that modern humans arrived in the Americas 15,000–20,000 y ago during the Late Pleistocene, most probably from northeast Asia through Beringia. However, there is still debate about the time of entry and number of migratory waves, including apparent inconsistencies between genetic and morphological data on Paleoamericans. Here we report the identification of mitochondrial sequences belonging to haplogroups characteristic of Polynesians in DNA extracted from ancient skulls of the now extinct Botocudo Indians from Brazil. The identification of these two Polynesian haplogroups was confirmed in independent replications in Brazil and Denmark, ensuring reliability of the data. Parallel analysis of 12 other Botocudo individuals yielded only the well-known Amerindian mtDNA haplogroup C1. Potential scenarios to try to help understand these results are presented and discussed. The findings of this study may be relevant for the understanding of the pre-Columbian and/or post-Columbian peopling of the Americas.

Body size and obesity patterns in Caboclo populations from Pará, Amazonia, Brazil

Abstract Background: In many developing countries overweight, obesity and obesity-related morbidity are becoming a problem of increasing public health importance. The purpose of this study was to investigate differences in body size and body composition with age in adults of the Caboclo populations from the Brazilian Amazon as well as to examine the prevalence of overweight and obesity in adults aged 20–75 years, taking into account recent trends for the whole country. Caboclo are genetically and culturally admixed rural peasant groups that live along the Amazon River and its tributaries in Brazil, and there are few previous studies of their health and lifestyle. Subjects and methods: A total of 304 subjects (149 males and 155 females) from two socioecologically different areas were studied. Height, weight and skinfolds (tricipital, subscapular and suprailiac) were measured; international intervals (WHO) for overweight and obesity were used. Results: Women showed significantly lower values than men for height, weight, upper arm circumference and fat-free mass and higher values for triceps, subscapular and suprailiac skinfolds and body fat (%). In the overall sample combined overweight and obesity was 47.8% in men and 50.8% in women. When compared to recent values published for the Northern region and for the whole of Brazil, 20.5% of Caboclo women aged 20–75 years were obese, which is higher than all other populations, including other rural samples. Caboclo men showed the highest rates of obesity (9.1%) and overweight (39.1%) of any rural population from the country, including Northern Brazil. Conclusion: The results suggest an effect of increased Western lifestyle influence on the body composition of these Caboclo populations. Considering that these are rural populations with limited access to education and health care, the high prevalence of overweight and obesity associated with low socio-economic status makes them a vulnerable group that deserves a higher level of attention by the countrys public health authorities.

Obesity, hypertension, social determinants of health and the epidemiologic transition among traditional Amazonian populations

Abstract Background: The health and nutritional situation of adults from three rural vulnerable Amazonian populations are investigated in relation to the Social Determinants of Health (SDH) and the epidemiologic transition. Aim: To investigate the role of the environment and the SDH on the occurrence of chronic-degenerative diseases in these groups. Subjects and methods: Anthropometric, blood pressure and demographic data were collected in adults from the RDS Mamirauá, AM (n = 149), Flona Caxiuanã, PA (n = 148) and quilombolas, PA (n = 351), populations living in a variety of socio-ecological environments in the Brazilian Amazon. Results: Adjusting for the effect of age, quilombola men are taller (F = 9.85; p < 0.001) and quilombola women present with higher adiposity (F = 20.43; p < 0.001) and are more overweight/obese. Men from Mamirauá present higher adiposity (F = 9.58; p < 0.001). Mamirauá women are taller (F = 5.55; p < 0.01) and have higher values of waist circumference and subscapular/triceps index. Quilombolas present higher prevalence of hypertension in both sexes and there are significant differences in rates of hypertension among the women (χ2 = 17.45; p < 0.01). The quilombolas are more dependent on government programmes, people from Mamirauá have more economic resources and the group from Caxiunã have the lowest SES. Conclusion: In these populations, the SDH play a key role in the ontogeny of diseases and the ‘diseases of modernity’ occur simultaneously with the always present infectoparasitic pathologies, substantially increasing social vulnerability.

Life is Hard, Life is Beautiful: Some Perspectives on Health and Aging in Amazonian Rural Populations

It is not easy to live in the Amazon. The difficulty of access to almost everything, from food to transport, makes life very hard in the vastness of the region. It has been called a “Green Hell” and a “Counterfeit Paradise,” yet people have adapted to it and survived for millennia. However, despite its demands, it is also wonderful to live and work in the Amazon, one of the most pristine and ecologically rich natural places on the planet. In this chapter some aspects of health and living conditions of Caboclo, rural peasants, in the state of Para, are presented and discussed in relation to each other, to other Amazonian groups, to the overall Brazilian population, and to other Latin American peoples, with the aim of providing some information about how it is to live, work, and grow old in the Amazon. Data presented come from a large ongoing study initiated in 1996 contrasting the floodplain (varzea) and the upland (terra firme) areas, during the wet and dry seasons in northern Brazil. The groups investigated include people from the Caxiuana National Forest, Portel, and of two communities living in the Ituqui Island, Santarem. Among other findings, the three groups present a high prevalence of undernutrition in children, and of obesity and hypertension in adults, indicative of their current epidemiological and nutritional transition, and causes for great public health concern since access to medical care continues to be one of the major challenges for the local communities.

O Projeto Mais Médicos para o Brasil: desafios e contribuições à Atenção Básica na visão dos médicos cooperados

O Projeto Mais Medicos para o Brasil (PMMB) foi criado em 2013 visando prover medicos para areas de dificil fixacao de profissionais e oferecer treinamento em Saude da Familia para medicos brasileiros e estrangeiros. Neste artigo, sao analisados aspectos relacionados as motivacoes, ao processo e condicoes de trabalho na Atencao Basica, a situacao de saude nos municipios, ao funcionamento do Sistema Unico de Saude (SUS) e a relacao com os gestores, a partir de entrevistas com 44 medicos cubanos, trabalhando em 32 municipios de todas as regioes do Brasil. As falas mostram que os cooperados tem um agudo senso de observacao e conseguem fazer um detalhado diagnostico situacional de suas areas de atuacao, demonstrando a precariedade ainda prevalente na Atencao Basica nos municipios. Porem, eles tambem evidenciam que, com a adequada formacao, e possivel fazer atencao primaria de qualidade, mesmo diante de grandes adversidades.O Projeto Mais Medicos para o Brasil (PMMB) foi criado em 2013 visando prover medicos para areas de dificil fixacao de profissionais e oferecer treinamento em Saude da Familia para medicos brasileiros e estrangeiros. Neste artigo, sao analisados aspectos relacionados as motivacoes, ao processo e condicoes de trabalho na Atencao Basica, a situacao de saude nos municipios, ao funcionamento do Sistema Unico de Saude (SUS) e a relacao com os gestores, a partir de entrevistas com 44 medicos cubanos, trabalhando em 32 municipios de todas as regioes do Brasil. As falas mostram que os cooperados tem um agudo senso de observacao e conseguem fazer um detalhado diagnostico situacional de suas areas de atuacao, demonstrando a precariedade ainda prevalente na Atencao Basica nos municipios. Porem, eles tambem evidenciam que, com a adequada formacao, e possivel fazer atencao primaria de qualidade, mesmo diante de grandes adversidades.

Avaliação situacional de biossegurança em tuberculose em Unidades Básicas de Saúde na Amazônia

Introducao: estudo sobre a biosseguranca dos profissionais de saude que atendem pacientes com tuberculose (TB) em duas Unidades Basicas de Saude na Amazonia brasileira, em Belem, no Para, sendo uma um Centro de Saude Escola e a outra uma Unidade Municipal de Saude (UMS) que atende o maior numero de casos na regiao. Objetivo: analisar os conhecimentos dos profissionais, a infraestrutura, as condutas e os recursos de biosseguranca em TB adotados nesses servicos. Metodo: utilizou-se entrevista semiestruturada com quem lida com os pacientes e um roteiro de observacao para avaliacao da estrutura fisica das unidades, ambos constituidos com base nas diretrizes para TB da Sociedade Brasileira de Pneumologia e Tisiologia. Resultados: a ausencia de medidas de biosseguranca e a deficiencia de capacitacao permanente comprometem a saude dos trabalhadores das unidades. O risco de transmissao da doenca parece ser maior na UMS devido a deficiencias na organizacao do atendimento e pela ausencia de um ambiente adequado que evite o contato direto de pacientes contagiantes com as demais pessoas. Conclusao: identificou-se a necessidade urgente de mudancas no ambiente e na organizacao do trabalho da UMS e de um programa de capacitacao permanente em TB para os profissionais de ambos os servicos.

Human Biology of the Amazon.

For the first time, the Olympic Games will be held in South America. The 31st Olympiad will take place in Rio de Janeiro 120 years after the first games of the modern era were initiated in Athens, ...