Prevalence of concomitant hypertension and diabetes among adults and elderly living in rural riverside areas in the Amazon.

INTRODUCTION: Considering the scarcity of information on the assessment of chronic diseases in traditional Amazonian populations, as well as public health policies focused on their specificities, this study aimed to estimate the prevalence of at least one of the chronic diseases (systemic arterial hypertension (SAH) or diabetes mellitus (DM)) and their concomitant occurrence in a rural riverside population of the Amazon, and determine the associated factors. METHODS: A household-based cross-sectional survey was conducted with a sample of adults and elderly people living in rural riverside locations along the left bank of the Negro River, in the municipality of Manaus, Amazonas, Brazil. The outcomes evaluated were the presence of at least one of the evaluated chronic diseases and the concomitant occurrence, based on the self-reported medical diagnosis of SAH and DM. Analysis of associated factors (sociodemographic, behavioral, and access to health services variables) was performed by Poisson regression with robust variance. RESULTS: The sample consisted of 495 individuals (young adults (n=257; 51.9%), middle-aged (n=132; 26.7%), and elderly (n=106; 21.4%)), of whom 51.5% were women (n=255), mean age 43.3±17.1 years. The monthly household income was on average R$1100±902 (A$345±283). The diagnosis of any chronic disease was reported by 18.8% of the sample, with a preponderance of SAH (17.4%). The occurrence of at least one of the chronic diseases was associated with higher average age and worse health self-assessment. Regarding concomitant occurrence of SAH and DM, prevalent in 4.4% of the sample, the same associations were observed. CONCLUSION: The data for the occurrence of chronic diseases in the studied Amazon rural riverside populations are worrying, because these people live in areas of socioeconomic vulnerability, with a lack of basic sanitation infrastructure, difficult geographic access, and limited access to health care. Health policies fail to recognize the specificities of these populations, which implies deficiencies in the provision of necessary regular care. The findings also reinforce the need to strengthen health promotion and chronic disease prevention strategies in the context of primary care.

Atenção diferenciada: a formação técnica de agentes indígenas de saúde do Alto Rio Negro / Differentiated attention: the technical training of indigenous health agents from the Upper Rio Negro

Em seus sete capítulos, a obra analisa etapas como o trabalho e a formação dos agentes comunitários e indígenas de saúde, as concepções político-pedagógicas e a organização curricular do Curso Técnico de Agentes Comunitários Indígenas de Saúde (CTACIS), os cuidados da saúde de crianças e mulheres indígenas, vigilância alimentar e nutricional em terra indígena, além de temas transversais, como território, cultura e política

Impressões e compreensões sobre uma comunidade rural na Amazônia, Brasil / Impressions and understandings of a rural community in the Amazon, Brazil / Impresiones y comprensiones sobre una comunidad rural en la Amazonia, Brasil

Este artigo expressa - por meio de um ensaio fotográfico em um projeto fotográfico de criação coletivo e interdisciplinar - a busca por captar Rio Pardo, uma comunidade rural amazônica. Metodologicamente, a proposta evitou um roteiro preestabelecido - baseando-se na noção de ensaísmo. Entre outros elementos, o trabalho foi executado, no geral, por fotógrafos de variadas formações acadêmicas, um caminho desafiador na intenção de apresentar a visão dos comunitários e evitar que as imagens fossem tratadas com menor importância em relação às ideias. Na etapa final, disporíamos de um emaranhado instigante de rotas-imagens para pavimentar nossa narrativa em conjunto.(AU)

This paper, which includes a photo essay as part of an interdisciplinary photographic project that was collectively created, is the expression of attempts to gather insights about Rio Pardo, a rural Amazonian community. The method proposed sought to avoid any predetermined script and was based on the notion of essay writing. Among its various components, the work was mainly carried out by photographers from different academic backgrounds, a route that was challenging but that aimed to present a vision of communities and avoid a situation in which the images would be considered less important than ideas. In the final phase, we had at our disposal an inspiring patchwork of route-images that together paved our narrative. (AU)

Este artículo expresa, por medio de un ensayo fotográfico en un proyecto fotográfico de creación colectiva e interdisciplinaria, la búsqueda por captar Rio Pardo, una comunidad rural amazónica. Metodológicamente, la propuesta evitó un itinerario preestablecido - basándose en la noción de ensayismo. Entre otros elementos, el trabajo fue ejecutado, en general, por fotógrafos de diversas formaciones académicas, un camino desafiador con la intención de presentar la visión de los comunitarios y evitar que las imágenes fuesen tratadas con menor importancia en relación a las ideas. En la etapa final, dispondremos de un enmarañado instigador de rutas-imágenes para pavimentar nuestra narrativa en conjunto.(AU)