Roberto Geraldo Baruzzi

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.

Squamous-cell carcinoma and lobomycosis (Jorge Lobo's disease)

Among the Cayabi Indians in Central Brazil, we found a high and unexpected prevalence of lobomycosis, which represents 21% of all the cases reported in the world medical literature until now. Most of the Cayabi patients have been observed for many years, and recently two developed cauliflower‐like tumours in old lobomycosis scar lesions. The diagnosis of squamous cell carcinoma was confirmed histologically. In both cases, the tumor was surgically removed, but several months later tumors recurred in both patients. The appearance of squamous cell carcinoma in chronic scar lesions and ulcers of various etiologies has been reported by many authors, and should include lobomycosis.

Perfil metabólico e antropométrico de índios Aruák: Mehináku, Waurá e Yawalapití, Alto Xingu, Brasil Central, 2000/2002

O objetivo deste trabalho foi descrever o perfil metabolico e antropometrico de indios Aruak (Mehinaku, Waura e Yawalapiti) que habitam o Alto Xingu, Brasil Central. Em julho de 2000 e outubro de 2002, 201 individuos de ambos os sexos e com idade > 20 anos foram submetidos a exames fisicos (antropometria e pressao arterial) e de laboratorio (glicemia de jejum, lipides sericos e acido urico). Indios do sexo masculino, quando comparados aos do sexo feminino, apresentaram valores medios menores de dobras cutâneas e de HDL colesterol, e maiores do indice de massa corporal, de circunferencia do braco, de pressao arterial sistolica e diastolica, de triglicerides, de VLDL e de acido urico. As prevalencias de sobrepeso (51,8%,), obesidade (15%), dislipidemia (77,1%) e niveis pressoricos elevados (37,7%) foram maiores entre os homens enquanto que as mulheres apresentaram maior prevalencia de obesidade abdominal (52,1%), independentemente da idade e da tribo de origem. Esses achados sugerem a necessidade de implementacao de medidas que visem tanto ao controle como a prevencao da obesidade e outros fatores de risco cardiovasculares entre esses individuos.

Perfil metabólico e antropométrico dos Suyá: Parque Indígena do Xingu, Brasil Central

OBJETIVO: Descrever o perfil metabolico e antropometrico de indios Suya que vivem no Parque Indigena do Xingu (Mato Grosso). METODO: Neste estudo transversal foram avaliados 86 indios Suya com idade de > 20 anos, de ambos os sexos. Durante o exame fisico foram obtidos os valores de pressao arterial, peso, altura, perimetros corporais e dobras cutâneas. Amostras de sangue foram coletadas para dosagem de lipoproteinas, glicemia e acido urico. Na analise dos dados foram utilizados os testes estatisticos qui-quadrado (para proporcoes) ou t de Student (para valores medios) nas comparacoes das distribuicoes das variaveis relativas ao estado nutricional e perfil metabolico, segundo sexo e faixa etaria dos sujeitos. RESULTADOS: As mulheres, quando comparadas aos homens, apresentaram valores medios estatisticamente menores das variaveis antropometricas (peso, indice de massa corporal, perimetro de cintura, do braco e dobras cutâneas), de pressao arterial, triglicerides, VLDL e acido urico. Foram encontrados, entre os Suya, 46,5%, com excesso de peso, 12,8% com obesidade generalizada, 38,4% com obesidade central, 26,7%, apresentaram alteracoes pressoricas, 4% glicemia de jejum alterada, 63,9% dislipidemia e 21,9% sindrome metabolica. CONCLUSAO: Foram observadas alteracoes metabolicas e antropometricas entre os indios Suya. Intervencoes educativas devem ser implementadas para resgatar habitos e estilo de vida tradicionais a fim de conter o avanco deste quadro.

Estado nutricional e níveis de hemoglobina em crianças Aruak e Karibe: povos indígenas do Alto Xingu, Brasil Central, 2001-2002

OBJETIVO: Avaliar o estado nutricional de criancas dos povos indigenas de familias linguisticas Aruak e Karibe do Alto Xingu, no Brasil Central, e verificar a associacao entre os niveis de hemoglobina das criancas segundo sexo, idade e estado nutricional. Foram estudadas, no total, 470 criancas menores de dez anos de idade em 2001/2002. METODOS: Para as criancas menores de cinco anos de idade, o diagnostico de desnutricao foi realizado com base nos indices altura/idade e peso/altura, adotando-se como ponto de corte dois desvios-padrao aquem da media esperada para idade e sexo da referencia - WHO, 2006. O diagnostico de excesso de peso foi definido de acordo com o indice peso/altura acima de dois desvios-padrao da media esperada da mesma referencia; as criancas com idade entre cinco e dez anos foram classificadas com baixo peso, sobrepeso ou obesidade de acordo com valores do indice de massa corporal, segundo sexo e idade, propostos por Cole e cols. O diagnostico de anemia foi determinado a partir de concentracoes de hemoglobina inferiores a 11,0 g/dL e inferiores a 11,5 g/dL para as criancas com idade entre 6 e 59 meses e entre 60 e 120 meses, respectivamente. RESULTADOS/CONCLUSAO: Verificou-se entre as criancas indigenas elevada prevalencia de deficit de estatura; a condicao de baixo peso praticamente inexiste e o excesso de peso e expressivo entre as criancas mais novas e as de maior idade. A magnitude da anemia alcanca cerca de 70% e a idade parece ser o principal fator associado as baixas concentracoes de hemoglobina.

Condições de nutrição em crianças Kamaiurá: povo indígena do Alto Xingu, Brasil Central

Este estudo teve por objetivo avaliar o estado nutricional, incluindo a prevalencia de anemia, de criancas Kamaiura, povo indigena do Alto Xingu, Brasil Central. Foram estudadas 112 criancas menores de dez anos de idade em 2000/2001. O perfil do crescimento infantil foi descrito segundo a distribuicao dos indices altura/idade e peso/altura expressos em escore-z da populacao de referencia do National Center of Health Statistics - NCHS. Os diagnosticos de deficit de altura e da relacao peso/altura e o diagnostico de obesidade corresponderam, respectivamente, aos valores abaixo de -2 escores-z de altura/idade e peso/altura e aos valores acima de 2 escores-z de peso/altura. O diagnostico de anemia foi determinado a partir de concentracoes de hemoglobina serica inferiores a 11 g/dl para criancas entre seis meses e cinco anos de idade e inferiores a 11,5 g/dl para as criancas com idade entre cinco e dez anos incompletos, conforme recomendacao da OMS. Aproximadamente um terco das criancas apresentou deficit de crescimento, enquanto deficit de peso/altura e obesidade nao foram diagnosticados entre elas. A anemia esteve presente em mais da metade das criancas indias estudadas, 15% delas apresentando anemia grave. Ha necessidade de implementacao de acoes que visem a melhoria das condicoes socioambientais, de saude e nutricao desse povo indigena.

Estado nutricional de crianças índias do Alto Xingu em 1980 e 1992 e evolução pondero-estatural entre o primeiro e o quarto anos de vida

This study focused on the under-five population of the Alto Xingu region in Brazil, with the following objectives: (1) to evaluate height and weight increment from the first through the fourth years of life and (2) to compare nutritional status in 1980 and 1992. Height and weight increases were evaluated in 81 children. Weight and height were measured in 264 children evaluated in 1980 and in 172 in 1992 (< 10 years of age). Median Z-scores in the first and fourth years of life, respectively, showed: (1) a decrease in weight-for-age, (-0.12 in the first year and -0.51 in the fourth year of life; p = 0.002); (2) a decrease in weight-for-height (+1.31 and +0.08; p < 0.001); (3) an increase in height-for-age (-1.50 and -0.94; p < 0.001). Median Z-scores in 1980 and 1992 showed: (1) no change in weight-for-age (-0.61 in 1980 and -0.62 in 1992; p = 0.90); (2) no change in weight-for-height (+0.27 and +0.34; p = 0.10); and (3) a decrease in height-for-age (-1.04 and -1.22; p = 0.02). Height-for-age increased and weight-for-height decreased between the first and fourth years of life. A decrease in height-for-age was observed from 1980 to 1992, demonstrating the importance of nutritional surveillance among the population of the Alto Xingu.

Rastreamento do câncer de colo uterino em índias do Parque Indígena do Xingu, Brasil central

Although the literature presents worrisome data regarding the incidence of cervical cancer among indigenous populations, in Brazil there is very little information regarding the occurrence of this type of cancer among indigenous peoples. Therefore, the objective of the present descriptive study was to assess the prevalence of cervical cancer and of cervical and vaginal infections among 423 indigenous women living in the Xingu Indian Reservation, in the state of Mato Grosso, Brazil. These women were or had been sexually active. Data were collected between 1989 and 1996. Clinical and gynecological examinations were carried out prior to the collection of cervical specimens and to the performance of cytologic analyses. Upon detection of abnormalities, a colposcopy and a biopsy were also performed. Our results show that 1% of the women studied presented invasive carcinoma and that 3% presented premalignant lesions. In addition, 84% presented inflammatory atypia, resulting from sexually transmitted genital infections. The present findings are in accordance with the results of other international reports regarding the high prevalence of cervical conditions among indigenous populations, and they underscore the need to extend to the indigenous peoples of Brazil programs aiming at the control of sexually transmitted diseases and at the early detection and treatment of cervical cancer.

Avaliação antropométrica de adolescentes Kamayurá, povo indígena do Alto Xingu, Brasil Central (2000-2001)

Despite the proximity between indigenous groups in the Upper Xingu Region and Brazilian national society, studies have shown adequate weight-for-height and low height-for-age in indigenous children. Little is known about the nutritional status of indigenous adolescents. The present study aimed to evaluate the nutritional status of Kamayura adolescents. Anthropometric variables were collected from a sample of 65 adolescents (31 males and 34 females). Mean height was lower than both that of the Brazilian National Survey on Health and Nutrition and the reference population of the U.S. National Center for Health Statistics. There was a high rate of overweight in both males (38.7%) and females (23.5%), and one female adolescent was obese (2.9%). No overweight adolescent presented both the triceps and subscapular skinfolds above the 90th percentile. There were no cases of nutritional deficit among either male or female adolescents. Despite the high prevalence of overweight, the nutritional status of these adolescents is adequate, since the group presents low adiposity.

[Nutritional status and body composition of two South American native populations -- Alto Xingu and Ikpeng].

OBJECTIVES To assess the nutritional and body composition of two Brazilian indigenous populations by comparing their nutritional status. METHODS 95 children from Alto Xingu and 69 from Ikpeng were evaluated, ages ranged from 24 to 117 months. The study was performed in the Xingu Indigenous Park. Data collected were: age, weight, height, skin folds, arm circumference, resistance and reactance. The z-scores were calculated and classified according to the parameters defined by the National Center for Health Statistics (NCHS 2000). Shortness was defined as length or stature below -2, underweight as body mass index below -2, and overweight as body mass index above 2. RESULTS Among children from Alto Xingu, the prevalence of shortness was 8.4%, while among Ikpengs the prevalence was 37.7% (p < 0.001). Underweight was diagnosed in 12.5% of Ikpeng s children. Values of fat-free mass were greater for children from Alto Xingu and no case of obesity was found. CONCLUSION In this study, Ikpengs children showed higher incidences of short stature and low weight than the Altoxingus children. Data regarding body composition have greater values among children from Alto Xingu, thus we conclude that nutritional status among children from Alto Xingu is better than the one found among the Ikpengs children.