Comparison of beriberi cases in indigenous and non-indigenous people, Brazil, 2013 to 2018. / Comparação dos casos de beribéri entre indígenas e não indígenas, Brasil, 2013 a 2018.

Beriberi is the clinical manifestation of severe and prolonged thiamine (vitamin B1) deficiency. It is a neglected disease that affects low-income populations facing food and nutrition insecurity. The aim of this study was to compare cases of beriberi among indigenous and non-indigenous people in Brazil. We conducted a cross-sectional study using data on cases of beriberi during the period July 2013-September 2018 derived from beriberi notification forms available on the FormSUS platform. Cases in indigenous and non-indigenous patients were compared using the chi-squared test or Fisher's exact test, adopting a significance level of 0.05. A total of 414 cases of beriberi were reported in the country during the study period, 210 of which (50.7%) were among indigenous people. Alcohol consumption was reported by 58.1% of the indigenous patients and 71.6% of the non-indigenous patients (p = 0.004); 71.0% of the indigenous patients reported that they consumed caxiri, a traditional alcoholic drink. Daily physical exertion was reported by 76.1% of the indigenous patients and 40.2% of the non-indigenous patients (p < 0.001). It is concluded that beriberi disproportionately affects indigenous people and is associated with alcohol consumption and physical exertion.

O beribéri é a manifestação clínica da deficiência grave e prolongada de tiamina (vitamina B1). Doença negligenciada que acomete a população de baixa renda, em situação de insegurança alimentar e nutricional. O objetivo do estudo foi comparar casos de beribéri em indígenas com casos em não indígenas no Brasil. Trata-se de estudo transversal de casos notificados de beribéri no período de 2013 a 2018, no formulário do SUS (FormSUS) do Ministério da Saúde. Foram comparados os casos em indígenas e em não indígenas pelo teste qui-quadrado ou teste exato de Fisher com nível de significância de p < 0,05. No período estudado foram notificados no país 414 casos de beribéri, sendo 210 (50,7%) indígenas. Referiram consumo de bebidas alcoólicas 58,1% dos indígenas e 71,6% dos não-indígenas (p = 0,004); adicionalmente, 71,0% dos indígenas consumiam caxiri (bebida alcoólica tradicional fermentada). Relataram fazer esforço físico diário 76,1% dos indígenas e 40,2% dos não-indígenas (p <0 ,001). Conclui-se que o beribéri no país acomete mais indígenas e está relacionado ao consumo de álcool e ao esforço físico.

Comparação dos casos de beribéri entre indígenas e não indígenas, Brasil, 2013 a 2018 / Comparison of beriberi cases in indigenous and non-indigenous people, Brazil, 2013 to 2018

Resumo O beribéri é a manifestação clínica da deficiência grave e prolongada de tiamina (vitamina B1). Doença negligenciada que acomete a população de baixa renda, em situação de insegurança alimentar e nutricional. O objetivo do estudo foi comparar casos de beribéri em indígenas com casos em não indígenas no Brasil. Trata-se de estudo transversal de casos notificados de beribéri no período de 2013 a 2018, no formulário do SUS (FormSUS) do Ministério da Saúde. Foram comparados os casos em indígenas e em não indígenas pelo teste qui-quadrado ou teste exato de Fisher com nível de significância de p < 0,05. No período estudado foram notificados no país 414 casos de beribéri, sendo 210 (50,7%) indígenas. Referiram consumo de bebidas alcoólicas 58,1% dos indígenas e 71,6% dos não-indígenas (p = 0,004); adicionalmente, 71,0% dos indígenas consumiam caxiri (bebida alcoólica tradicional fermentada). Relataram fazer esforço físico diário 76,1% dos indígenas e 40,2% dos não-indígenas (p <0 ,001). Conclui-se que o beribéri no país acomete mais indígenas e está relacionado ao consumo de álcool e ao esforço físico.

Abstract Beriberi is the clinical manifestation of severe and prolonged thiamine (vitamin B1) deficiency. It is a neglected disease that affects low-income populations facing food and nutrition insecurity. The aim of this study was to compare cases of beriberi among indigenous and non-indigenous people in Brazil. We conducted a cross-sectional study using data on cases of beriberi during the period July 2013-September 2018 derived from beriberi notification forms available on the FormSUS platform. Cases in indigenous and non-indigenous patients were compared using the chi-squared test or Fisher's exact test, adopting a significance level of 0.05. A total of 414 cases of beriberi were reported in the country during the study period, 210 of which (50.7%) were among indigenous people. Alcohol consumption was reported by 58.1% of the indigenous patients and 71.6% of the non-indigenous patients (p = 0.004); 71.0% of the indigenous patients reported that they consumed caxiri, a traditional alcoholic drink. Daily physical exertion was reported by 76.1% of the indigenous patients and 40.2% of the non-indigenous patients (p < 0.001). It is concluded that beriberi disproportionately affects indigenous people and is associated with alcohol consumption and physical exertion.

Beriberi in Brazil: A Disease That Affects Indigenous People.

BACKGROUND: Beriberi is the clinical manifestation of thiamine deficiency. It is multicausal and typically associated with poverty and food insecurity among vulnerable populations, such as indigenous people. OBJECTIVE: The objective of this study was to carry out a spatial analysis of reported cases of beriberi among indigenous people in Brazil. METHODS: Cross-sectional study using time series data on suspected cases of beriberi reported to the Ministry of Health via the FormSUS between July 2013 and September 2018. Indigenous villages were georeferenced, and Kernel density estimation was used to identify patterns of the spatial distribution of beriberi cases. RESULTS: A total of 414 cases of beriberi were reported in the country of which 210 (50.7%) were indigenous people. All the cases in indigenous people occurred in states located in the Legal Amazon (Maranhão, Roraima, and Tocantins). Kernel density estimation showed high-density areas in Tocantins and Roraima. CONCLUSIONS: This is the first nationwide study of reported cases of beriberi. The findings can be used to guide actions that contribute to the monitoring and prevention of beriberi among indigenous people.

Fatores associados à presença de Candida spp. em amostras de fluido vaginal de mulheres residentes em comunidades quilombolas / Factors associated with the presence of Candida spp. in vaginal fluid samples from women living in quilombola settlements

RESUMO: Objetivo: Investigar a frequência e fatores associados à detecção de Candida spp. em fluido vaginal de mulheres residentes em uma comunidade quilombola. Materiais e Método: Um estudo transversal foi conduzido com 177 mulheres residentes em uma comunidade quilombola no Nordeste do Brasil. Foram coletados dados sociodemográficos, hábitos de vida, saúde geral e saúde reprodutiva. O material coletado na região do colo do útero foi submetido a exame citopatológico. Amostras de fluido vaginal foram coletadas para a análise microbiológica. Os testes Qui-quadrado, exato de Fisher e modelos de Re-gressão Logística foram utilizados na análise estatística. Resultados: Foi detectado Candida spp. em 28,9% das amostras. A espécie mais frequente nos casos positivos foi a Candida albicans (49%), seguida da Candida krusei (39,2%). Após o ajustamento, observou-se que mulheres com idade igual ou maior que 50 anos apresentaram maior chance da detecção de Candida spp. no fluido vaginal (OR ajustada = 3,46; IC95% = 1,68-7,12), enquanto as mulheres com queixa de corrimento vaginal apresentaram uma chance menor de detecção de Candida spp. (OR ajustada = 0,29; IC95% = 0,11-0,78). Conclusão: Os achados sugerem uma elevada detecção de Candida spp. no fluido vaginal entre mulheres residentes em comunidades quilombolas, o que sinaliza a necessidade do planejamento de medidas para prevenção e rastreamento de caso de candidíase vulvovaginal neste grupo populacional. Além disso, a presença de Candida spp. foi mais elevada em mulheres a partir da quinta década de vida, menor nas mulheres com queixas de corrimento vaginal. (AU)

ABSTRACT: Objective: Investigate the frequency and factors associated with the detection of Candida spp. in vaginal fluid from women living in a quilombola settlement. Materials and Method: A cross-sectional study was conducted with 177 women living in a quilombola settlement in Northeast, Brazil. Socio-demographic data, living habits, general health, and reproductive health were collected. The material collected in the region of the cervix was submitted to cytopathological examination. Vaginal fluid samples were collected for microbiological analysis. Chi-square test, exact Fisher's test, and logistic regression models were used for the statistical analysis. Results: Candida spp. was detected in 28.9% of the samples. The most frequent species in positive cases were Candida albicans (49%), followed by Candida krusei (39.2%). After adjustment, it was observed that women aged over 50 years had a higher chance of detecting Candida spp. in vaginal fluid (OR adjusted = 3.46; 95% CI = 1.68-7.12), while women complaining of vaginal discharge had a lower chance of detecting Candida spp. (OR adjust-ed = 0.29; 95% 95% CI= 0.11-0.78). Conclusion: The findings suggest a high detection of Candida spp. in vaginal fluid among women living in quilombola settlements, which indicates the need for planning measures for prevention and track the cases of vulvovaginal candidiasis in this population group. Besides, the presence of Candida spp. was higher in women from the fifth decade of life, lower in women with complaints of vaginal discharge. (AU)