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1.
Sci Rep ; 14(1): 10142, 2024 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-38698247

RESUMO

Indigenous health has posted complex challenges worldwide, particularly due to historical economic, territorial, social and environmental processes, which may lead to emergence and reemergence of pathogens. In addition to few Coxiella burnetii serosurveys in vulnerable populations, especially in developing tropical countries, no comprehensive One Health approach has focused on human-animal infection along with potential environmental determinants. Accordingly, this study aimed to assess the seroprevalence of anti-C. burnetii antibodies in indigenous populations and their dogs from 10 indigenous communities distributed in southern and southeastern Brazil, along with the correspondent healthcare professionals. In overall, 8/893 (0.90%; 95% CI 0.45-1.76) indigenous and 1/406 (0.25%) dog samples were seropositive, with 7/343 (2.04%) individuals the 1/144 (0.69%) dog from the Ocoy community, located in the city of São Miguel do Iguaçu, bordering Argentina at south, and far 10 km at west from Paraguay. All 84 healthcare professionals tested seronegative.


Assuntos
Coxiella burnetii , Saúde Única , Febre Q , Brasil/epidemiologia , Coxiella burnetii/imunologia , Animais , Humanos , Febre Q/epidemiologia , Febre Q/microbiologia , Estudos Soroepidemiológicos , Cães , Masculino , Feminino , Adulto , Anticorpos Antibacterianos/sangue , Adolescente , Povos Indígenas , Pessoa de Meia-Idade , Adulto Jovem , Criança , Doenças do Cão/epidemiologia , Doenças do Cão/microbiologia , Pré-Escolar , Idoso
2.
Front Public Health ; 12: 1376748, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38807996

RESUMO

Cervical cancer, primarily caused by human papillomavirus (HPV) infection, poses a significant global health challenge. Due to higher levels of poverty and health inequities, Indigenous women worldwide are more vulnerable to cervical cancer than their non-Indigenous counterparts. However, despite constituting nearly 10% of the population in Latin America and the Caribbean (LAC), the true extent of the burden of cervical cancer among Indigenous people in this region remains largely unknown. This article reviews the available information on cervical cancer incidence and mortality, as well as HPV infection prevalence, among Indigenous women in LAC. The limited existing data suggest that Indigenous women in this region face a heightened risk of cervical cancer incidence and mortality compared to non-Indigenous women. Nevertheless, a substantial knowledge gap persists that must be addressed to comprehensively assess the burden of cervical cancer among Indigenous populations, especially through enhancing cancer surveillance across LAC countries. Numerous structural, social and cultural barriers hindering Indigenous women's access to HPV vaccination and cervical cancer screening worldwide have been identified and are reviewed in this article. The discussion highlights the critical role of culturally sensitive education, community engagement, and empowerment strategies in overcoming those barriers. Drawing insights from the success of targeted strategies in certain high-income countries, the present article advocates for research, policies and healthcare interventions tailored to the unique context of LAC countries.


Assuntos
Infecções por Papillomavirus , Neoplasias do Colo do Útero , Humanos , Neoplasias do Colo do Útero/prevenção & controle , Feminino , América Latina/etnologia , Região do Caribe/etnologia , Infecções por Papillomavirus/prevenção & controle , Povos Indígenas/estatística & dados numéricos , Incidência , Vacinas contra Papillomavirus/administração & dosagem , Detecção Precoce de Câncer/estatística & dados numéricos , Prevalência
3.
Epidemiol Serv Saude ; 33: e20231075, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-38808804

RESUMO

OBJECTIVE: To analyze the temporal trend of completeness and consistency of data on notifications of violence against indigenous women in the health macro-region of Dourados, state of Mato Grosso do Sul, Brazil, between 2009 and 2020. METHODS: An ecological time series study was conducted using data from the Notifiable Health Conditions Information System; Prais-Winsten regression was used to analyze the trend of data completeness and consistency, as well as the proportion of completed and coherent fields. RESULTS: A total of 2,630 cases were reported; completeness was found to be very poor in the variable "occupation" (48.9%) and poor in the variables "schooling" (68.3%) and "time of occurrence" (67.9%); in the analysis of temporal trends, only the variable "occupation" showed a decreasing trend (p = 0.045). CONCLUSION: The data analyzed demonstrated the need for improvement in the completeness of the variables "schooling", "occupation" and "time of occurrence" of the violent act. MAIN RESULTS: There was a progressive increase in notifications over the years. Most of the variables showed regular or excellent completeness and consistency. In the analysis of temporal trend, only the "occupation" variable showed a decreasing trend. IMPLICATIONS FOR SERVICES: Care for victims of violence is part of the daily routine of health services, and it is essential for health professionals to provide adequate compulsory notification for a comprehensive understanding of the victims' profile, thus assisting in addressing this issue. PERSPECTIVES: Further studies are needed to understand the factors associated with violence against indigenous women, which could help the development of health promotion actions and violence prevention strategies targeting these women.


Assuntos
Violência , Humanos , Brasil , Feminino , Violência/estatística & dados numéricos , Fatores de Tempo , Indígenas Sul-Americanos/estatística & dados numéricos , Violência de Gênero/estatística & dados numéricos , Povos Indígenas/estatística & dados numéricos , Escolaridade , Adulto , Sistemas de Informação
4.
BMJ Open ; 14(5): e079942, 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38772588

RESUMO

INTRODUCTION: Improving the health of Indigenous adolescents is central to addressing the health inequities faced by Indigenous peoples. To achieve this, it is critical to understand what is needed from the perspectives of Indigenous adolescents themselves. There have been many qualitative studies that capture the perspectives of Indigenous young people, but synthesis of these has been limited to date. METHODS AND ANALYSIS: This scoping review seeks to understand the specific health needs and priorities of Indigenous adolescents aged 10-24 years captured via qualitative studies conducted across Australia, Aotearoa New Zealand, Canada, the USA, Greenland and Sami populations (Norway and Sweden). A team of Indigenous and non-Indigenous researchers from these nations will systematically search PubMed (including the MEDLINE, PubMed Central and Bookshelf databases), CINAHL, Embase, Scopus, the Informit Indigenous and Health Collections, Google Scholar, Arctic Health, the Circumpolar Health Bibliographic Database, Native Health Database, iPortal and NZresearch.org, as well as specific websites and clearinghouses within each nation for qualitative studies. We will limit our search to articles published in any language during the preceding 5 years given that needs may have changed significantly over time. Two independent reviewers will identify relevant articles using a two-step process, with disagreements resolved by a third reviewer and the wider research group. Data will then be extracted from included articles using a standardised form, with descriptive synthesis focussing on key needs and priorities. This scoping review will be conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. ETHICS AND DISSEMINATION: Ethics approval was not required for this review. Findings will be disseminated via a peer-reviewed journal article and will inform a broader international collaboration for Indigenous adolescent health to develop evidence-based actions and solutions.


Assuntos
Povos Indígenas , Pesquisa Qualitativa , Projetos de Pesquisa , Humanos , Adolescente , Criança , Adulto Jovem , Saúde do Adolescente , Austrália , Necessidades e Demandas de Serviços de Saúde , Nova Zelândia , Canadá , Literatura de Revisão como Assunto , Serviços de Saúde do Indígena
6.
PLoS One ; 19(5): e0302816, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38781231

RESUMO

Cardiovascular disease is a leading cause of death worldwide, with disproportionate impacts on Indigenous Peoples in Canada. In Spring 2022, a land-based learning program was piloted and evaluated as an Indigenous cultural safety training for professionals at a cardiac care centre and university in a large urban city. Baseline and endline surveys showed an increase in knowledge of Indigenous histories, cultures, and practices; increased reflection on positionality and intention to create change; and strengthened relationships with the land. Future work should explore the long-term effects of land-based cultural safety training on participant behaviours, and health outcomes for Indigenous Peoples.


Assuntos
Insuficiência Cardíaca , Humanos , Ontário , Insuficiência Cardíaca/etnologia , Insuficiência Cardíaca/terapia , Masculino , Feminino , Povos Indígenas , Pessoal de Saúde/educação , Adulto
7.
Health Res Policy Syst ; 22(1): 57, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38741196

RESUMO

BACKGROUND: Indigenous populations have increased risk of developing diabetes and experience poorer treatment outcomes than the general population. The FORGE AHEAD program partnered with First Nations communities across Canada to improve access to resources by developing community-driven primary healthcare models. METHODS: This was an economic assessment of FORGE AHEAD using a payer perspective. Costs of diabetes management and complications during the 18-month intervention were compared to the costs prior to intervention implementation. Cost-effectiveness of the program assessed incremental differences in cost and number of resources utilization events (pre and post). Primary outcome was all-cause hospitalizations. Secondary outcomes were specialist visits, clinic visits and community resource use. Data were obtained from a diabetes registry and published literature. Costs are expressed in 2023 Can$. RESULTS: Study population was ~ 60.5 years old; 57.2% female; median duration of diabetes of 8 years; 87.5% residing in non-isolated communities; 75% residing in communities < 5000 members. Total cost of implementation was $1,221,413.60 and cost/person $27.89. There was increase in the number and cost of hospitalizations visits from 8/$68,765.85 (pre period) to 243/$2,735,612.37. Specialist visits, clinic visits and community resource use followed this trend. CONCLUSION: Considering the low cost of intervention and increased care access, FORGE AHEAD represents a successful community-driven partnership resulting in improved access to resources.


Assuntos
Análise Custo-Benefício , Diabetes Mellitus , Serviços de Saúde do Indígena , Hospitalização , Atenção Primária à Saúde , Humanos , Atenção Primária à Saúde/economia , Feminino , Masculino , Pessoa de Meia-Idade , Hospitalização/economia , Canadá , Serviços de Saúde do Indígena/economia , Diabetes Mellitus/terapia , Atenção à Saúde/economia , Idoso , Acessibilidade aos Serviços de Saúde , Custos de Cuidados de Saúde , Indígenas Norte-Americanos , Povos Indígenas , Adulto , Complicações do Diabetes/terapia , Complicações do Diabetes/economia
8.
J Cross Cult Gerontol ; 39(2): 189-205, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38717711

RESUMO

The phenomenon of world aging is not foreign to indigenous communities. In the last few years, research about these communities around the world has increased, but aging in indigenous towns still has not been studied widely. The purpose of this research is to interpret the meaning of old age in two indigenous communities from the Colombian Andean-Amazon region (the Inga and Kamëntsa) to reinforce the relevance of the local sociocultural context within the configuration of the meaning of old age and to emphasize the importance of considering particular regional characteristics for the design of policies and interventions aiming to recognize and integrate indigenous populations. This is a qualitative study with an interactionism-symbolism approach. In total, six indigenous people older than 60 years from two ancestral communities from the Colombian Andean-Amazon region participated in the in-depth interviews. Data analysis was carried out in three moments: discovery, coding, and relativization of the information. The results show that old age means wisdom, "I am wise," which is supported in the cosmology and the trajectory of life, reinforces the identity and autonomy, and allows them to be agents in the dynamics of their communities from the "I do," in other words, their roles as builders of the family-society and as guards of ancestral knowledge. The loss of this knowledge and the elements that it is composed of uproot them and put them at risk of disappearing as individuals and as a collective. In conclusion, the meaning of old age in these communities is not centered on a determinate age; you are not old, you are wise, and as such, they play a central role in their communities. Moreover, wisdom is built in parallel with their cosmology and assigns them the task of safekeeping ancestral knowledge. In order to do this, they use oral tradition as a tool, words that are born in their territories, travel in a nonlinear timeline, and get strengthened by the community while also protecting it and building it. Knowing what aging means for Indigenous communities can facilitate to the development of policies and initiatives and to provide culturally appropriate and effective programs.


Assuntos
Envelhecimento , Indígenas Sul-Americanos , Povos Indígenas , Pesquisa Qualitativa , Humanos , Colômbia/etnologia , Feminino , Masculino , Envelhecimento/etnologia , Idoso , Pessoa de Meia-Idade , Entrevistas como Assunto , Idoso de 80 Anos ou mais
10.
Sci Rep ; 14(1): 11150, 2024 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-38750053

RESUMO

Numerous genetic studies have contributed to reconstructing the human history of the Canary Islands population. The recent use of new ancient DNA targeted enrichment and next-generation sequencing techniques on new Canary Islands samples have greatly improved these molecular results. However, the bulk of the available data is still provided by the classic mitochondrial DNA phylogenetic and phylogeographic studies carried out on the indigenous, historical, and extant human populations of the Canary Islands. In the present study, making use of all the accumulated mitochondrial information, the existence of DNA contamination and archaeological sample misidentification in those samples is evidenced. Following a thorough review of these cases, the new phylogeographic analysis revealed the existence of a heterogeneous indigenous Canarian population, asymmetrically distributed across the various islands, which most likely descended from a unique mainland settlement. These new results and new proposed coalescent ages are compatible with a Roman-mediated arrival driven by the exploitation of the purple dye manufacture in the Canary Islands.


Assuntos
DNA Antigo , DNA Mitocondrial , Filogeografia , Humanos , DNA Mitocondrial/genética , DNA Antigo/análise , Espanha , Filogenia , Genética Populacional , Povos Indígenas/genética , Arqueologia , Migração Humana , História Antiga , Sequenciamento de Nucleotídeos em Larga Escala
11.
Med Educ Online ; 29(1): 2350251, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38720424

RESUMO

BACKGROUND: Indigenous Peoples in Canada bear a disproportionate burden of disease and experience poorer health outcomes as compared to non-Indigenous populations within Canada; these conditions are said to be mediated and exacerbated by pervasive and uninterrupted anti-Indigenous racism. Third and fourth-year medical students at a Canadian medical school were asked to reflect on their experiences working with Indigenous patients in clinical settings, and how their preclinical Indigenous health curriculum impacted these experiences. METHOD: Phenomenology was used, guided by Goffman's theory of social stigma. Eleven undergraduate medical students were recruited using purposeful sampling. Semi-structured phone interviews were conducted to gain an in-depth understanding of the participants' experiences. Interviews were recorded and transcribed verbatim. Data were analyzed using the four main processes for phenomenological analysis. RESULTS: Four main themes emerged from students' descriptions of clinical experiences involving Indigenous patients: 1) students describe how their Indigenous patients encounter the health care system and their own lack of cultural sensitivity in this context; 2) racism was evident in students' clinical interactions with Indigenous patients, but students do not always perceive these biases nor the impact of this on patient care; 3) identifying the impact of racism on care is complicated by situational clinical encounters; and 4) practicality of preclinical Indigenous health education is desired by students to prepare them for working with Indigenous patients in the clinical setting. CONCLUSIONS: In their clinical experiences, students witness racism against Indigenous peoples yet are unprepared to stand up against it. Findings highlight the importance of enhancing undergraduate medical training to allow students to better understand the unique experiences and perspectives of Indigenous patients. The results support the need for ongoing Indigenous health education, to foster culturally sensitive experiences while learning about Indigenous patients.


Assuntos
Racismo , Estudantes de Medicina , Humanos , Estudantes de Medicina/psicologia , Canadá , Racismo/psicologia , Feminino , Masculino , Serviços de Saúde do Indígena/organização & administração , Competência Cultural , Entrevistas como Assunto , Educação de Graduação em Medicina , Pesquisa Qualitativa , Povos Indígenas/psicologia , Adulto , Atitude do Pessoal de Saúde
12.
Soc Sci Med ; 350: 116936, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38728976

RESUMO

Indigenous Peoples are exposed to the impacts of the climatic, ecological and socioeconomic changes, yet there is a need for a better understanding of their health and higher involvement of Indigenous Peoples in health promotion design and implementation. Our study brings empirical data on the healthcare system of the Baka, forager-horticulturalists from Cameroon. Using a mixed methods approach, we explored the health issues they encounter, the emic determinants of health and healthcare system, and the different threats towards their healthcare system. We conducted focus group discussions, interviews with experts, and self-reported health recalls with 302 individuals living in two settlements from southeastern Cameroon during two fieldwork periods between June and November 2022. Our insights highlight the prevalence of respiratory and children's digestive issues, and the occurrence of illnesses implying a combination of symptoms that would deserve further Western biomedical attention. The Baka's healthcare relies on medicinal plants, knowledge experts, and on the social cohesion of the community, all largely affected by the local social-ecological impacts of global change. Exposure to the market and health facilities does not seem to relate to Baka's health state and practices but might affect their perception of health. Deforestation, poor water quality, and alcohol (ab)use were reported and observed threats to the Baka's health and healthcare system. Our work supplies empirical evidence for a better understanding of Baka's health and healthcare system, helpful in designing health prevention and policies adapted to their reality and culture. Further research and interventions on health should consider the current threats to Baka's local ecosystems and cultural knowledge. These insights contribute to a higher recognition of the Baka's, and most broadly, the Indigenous Peoples' emic perspective on health, and on culturally grounded indicators of the resilience of their healthcare system to current and future challenges.


Assuntos
Grupos Focais , Povos Indígenas , Humanos , Camarões , Povos Indígenas/psicologia , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adolescente , Idoso
13.
Int J Equity Health ; 23(1): 90, 2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38698390

RESUMO

BACKGROUND: There is a growing interest in employing community wellness worker models in Indigenous populations to address inequities in healthcare access and outcomes, concerns about shortage in health and mental health human resources, and escalating burden of chronic and complex diseases driving significant increase in health services demand and costs. A thorough review of Indigenous community wellness worker models has yet to be conducted. This rapid review sought to outline the characteristics of a community wellness worker model in Indigenous contexts across the globe, detailing factors shaping implementation challenges and success. METHODS: A rapid review of the international peer-reviewed and grey literature of OVID Medline, Global Index Medicus, Google, and Google Scholar was conducted from January to June 2022 for Indigenous community wellness/mental health worker models and comparative models. Articles were screened and assessed for eligibility. From eligible articles, data pertaining to study design and sample; description of the program, service, or intervention; model development and implementation; terminology used to describe workers; training features; job roles; funding considerations; facilitators and barriers to success; key findings; outcomes measured; and models or frameworks utilized were extracted. Data were synthesized by descriptive and pattern coding. RESULTS: Twenty academic and eight grey literature articles were examined. Our findings resulted in four overarching and interconnected themes: (1) worker roles and responsibilities; (2) worker training, education, and experience; (3) decolonized approaches; and (4) structural supports. CONCLUSION: Community wellness worker models present a promising means to begin to address the disproportionately elevated demand for mental wellness support in Indigenous communities worldwide. This model of care acts as a critical link between Indigenous communities and mainstream health and social service providers and workers fulfill distinctive roles in delivering heightened mental wellness supports to community members by leveraging strong ties to community and knowledge of Indigenous culture. They employ innovative structural solutions to bolster their efficacy and cultivate positive outcomes for service delivery and mental wellness. Barriers to the success of community wellness worker models endure, including power imbalances, lack of role clarity, lack of recognition, mental wellness needs of workers and Indigenous communities, and more.


Assuntos
Agentes Comunitários de Saúde , Serviços de Saúde do Indígena , Humanos , Agentes Comunitários de Saúde/psicologia , Promoção da Saúde/métodos , Povos Indígenas/psicologia , Acessibilidade aos Serviços de Saúde
14.
BMC Public Health ; 24(1): 1210, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38693512

RESUMO

BACKGROUND: Available data show that the epidemiological profile of most indigenous Brazilian populations is characterized by the coexistence of long-standing health problems (high prevalence of infectious and parasitic diseases, malnutrition, and deficiency diseases, such as anemia in children and women of reproductive age), associated with new health problems, especially those related to obesity (hypertension, type 2 diabetes mellitus and dyslipidemia). Based on this scenario, this study analyzed the nutritional profile of the adult population of seven indigenous peoples from the Brazilian Amazon in the years 2007 and 2021. METHODS: A total of 598 adults individuals were analyzed in 2007 (319 women and 279 men) and 924 in 2021 (483 women and 441 men), from seven indigenous peoples located in the state of Pará, who were assisted during health actions carried out in 2007 and in 2021. Body mass index classification used the World Health Organization criteria for adults: low weight, < 18.5 kg/m2; normal weight, ≥ 18.5 and < 25 kg/m2); overweight, ≥ 25 and < 30 kg/m2, and obesity, ≥ 30 kg/m2. A waist circumference (WC) < 90 cm in men and < 80 cm in women was considered normal. RESULTS: The data revealed heterogeneous anthropometric profiles, with a low prevalence of nutritional changes in the Araweté, Arara and Parakanã peoples, and high proportions of excess weight and abdominal obesity in the Kararaô, Xikrin do Bacajá, Asurini do Xingu and Gavião peoples, similar to or even higher than the national averages. CONCLUSION: Different stages of nutritional transition were identified in the indigenous peoples analyzed, despite apparently having been subjected to the same environmental pressures that shaped their nutritional profile in recent decades, which may indicate different genetic susceptibilities to nutritional changes. The evidence shown in this study strongly suggests the need to investigate in greater depth the genetic and environmental factors associated with the nutritional profile of Brazilian indigenous peoples, with assessment of diet, physical activity and sociodemographic and socioeconomic variables that enable the development of appropriate prevention and monitoring measures.


Assuntos
Indígenas Sul-Americanos , Obesidade Abdominal , Obesidade , Sobrepeso , Humanos , Brasil/epidemiologia , Feminino , Masculino , Adulto , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/etnologia , Indígenas Sul-Americanos/estatística & dados numéricos , Sobrepeso/epidemiologia , Sobrepeso/etnologia , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/etnologia , Adulto Jovem , Prevalência , Povos Indígenas/estatística & dados numéricos , Adolescente
15.
BMC Health Serv Res ; 24(1): 553, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38693527

RESUMO

BACKGROUND: Indigenous adolescents access primary health care services at lower rates, despite their greater health needs and experience of disadvantage. This systematic review identifies the enablers and barriers to primary health care access for Indigenous adolescents to inform service and policy improvements. METHODS: We systematically searched databases for publications reporting enablers or barriers to primary health care access for Indigenous adolescents from the perspective of adolescents, their parents and health care providers, and included studies focused on Indigenous adolescents aged 10-24 years from Australia, Canada, New Zealand, and United States of America. Results were analyzed against the WHO Global standards for quality health-care services for adolescents. An additional ninth standard was added which focused on cultural safety. RESULTS: A total of 41 studies were included. More barriers were identified than enablers, and against the WHO Global standards most enablers and barriers related to supply factors - providers' competencies, appropriate package of services, and cultural safety. Providers who built trust, respect, and relationships; appropriate package of service; and culturally safe environments and care were enablers to care reported by adolescents, and health care providers and parents. Embarrassment, shame, or fear; a lack of culturally appropriate services; and privacy and confidentiality were common barriers identified by both adolescent and health care providers and parents. Cultural safety was identified as a key issue among Indigenous adolescents. Enablers and barriers related to cultural safety included culturally appropriate services, culturally safe environment and care, traditional and cultural practices, cultural protocols, Indigenous health care providers, cultural training for health care providers, and colonization, intergenerational trauma, and racism. Nine recommendations were identified which aim to address the enablers and barriers associated with primary health care access for Indigenous adolescents. CONCLUSION: This review provides important evidence to inform how services, organizations and governments can create accessible primary health care services that specifically meet the needs of Indigenous adolescents. We identify nine recommendations for improving the accessibility of primary health care services for Indigenous adolescents.


Assuntos
Acessibilidade aos Serviços de Saúde , Serviços de Saúde do Indígena , Povos Indígenas , Atenção Primária à Saúde , Adolescente , Humanos , Austrália , Canadá , Nova Zelândia , Atenção Primária à Saúde/normas , Estados Unidos
17.
Sci Rep ; 14(1): 11822, 2024 05 23.
Artigo em Inglês | MEDLINE | ID: mdl-38782949

RESUMO

Indigenous communities in Brazil have a complex epidemiological profile, which increases their chances of contracting sexually transmitted diseases. However, limited data is available on Treponema pallidum infections in this population. We investigated the seroprevalence and risk factors associated with T. pallidum infection in an indigenous population of Dourados, Mato Grosso do Sul. Blood samples were collected from September 2017 to March 2020, and the participants were interviewed to obtain comprehensive data on demography and sexual behavior. Serological tests were performed to detect T. pallidum infection. Besides conducting descriptive analysis, we performed Chi-squared tests and determined the bivariate odds ratio. The data were also analyzed using logistic regression. Among the 2190 invited individuals, 1927 (88%) were included in this study. The seroprevalence of T. pallidum infection was 2.91%. The results of a multivariate analysis showed that individuals who were 30-39 years old, with up to 4 years of school education, living in households without piped water, with a history of genital lesions, multiple sexual partners, and having a history of STIs had the highest seroprevalence of T. pallidum. This study showed that behavioral, social, and economic factors play an important role in the transmission of T. pallidum within the indigenous population. Thus, targeted intervention, including imparting education in the native language, mass testing initiatives, and implementing public policies to improve socioeconomic indicators, is needed to reduce the cases of syphilis in this community.


Assuntos
Sífilis , Treponema pallidum , Humanos , Brasil/epidemiologia , Masculino , Adulto , Feminino , Sífilis/epidemiologia , Sífilis/sangue , Estudos Soroepidemiológicos , Estudos Transversais , Treponema pallidum/imunologia , Adulto Jovem , Pessoa de Meia-Idade , Adolescente , Fatores de Risco , Povos Indígenas , Comportamento Sexual
18.
Rural Remote Health ; 24(2): 8674, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38697785

RESUMO

INTRODUCTION: Māori (the Indigenous Peoples of Aotearoa New Zealand) are disproportionately represented in cardiovascular disease (CVD) prevalence, morbidity and mortality rates, and are less likely to receive evidence-based CVD health care. Rural Māori experience additional barriers to treatment access, poorer health outcomes and a greater burden of CVD risk factors compared to Non-Māori and Māori living in urban areas. Importantly, these inequities are similarly experienced by Indigenous Peoples in other nations impacted by colonisation. Given the scarcity of available literature, a systematic scoping review was conducted on literature exploring barriers and facilitators in accessing CVD health care for rural Māori and other Indigenous Peoples in nations impacted by colonisation. METHODS: The review was underpinned by Kaupapa Māori Research methodology and was conducted utilising Arksey and O'Malley's (2005) methodological framework. A database search of MEDLINE (OVID), PubMed, Embase, SCOPUS, CINAHL Plus, Australia/New Zealand Reference Centre and NZResearch.org was used to explore empirical research literature. A grey literature search was also conducted. Literature based in any healthcare setting providing care to adults for CVD was included. Rural or remote Indigenous Peoples from New Zealand, Australia, Canada, and the US were included. Literature was included if it addressed cardiovascular conditions and reported barriers and facilitators to healthcare access in any care setting. RESULTS: A total of 363 articles were identified from the database search. An additional 19 reports were identified in the grey literature search. Following screening, 16 articles were included from the database search and 5 articles from the grey literature search. The literature was summarised using the Te Tiriti o Waitangi (Treaty of Waitangi) Framework principles: tino rangatiratanga (self-determination), partnership, active protection, equity and options. Themes elucidated from the literature were described as key drivers of CVD healthcare access for rural Indigenous Peoples. Key driver themes included input from rural Indigenous Peoples on healthcare service design and delivery, adequate resourcing and support of indigenous and rural healthcare services, addressing systemic racism and historical trauma, providing culturally appropriate health care, rural Indigenous Peoples' access to family and wellbeing support, rural Indigenous Peoples' differential access to the wider social determinants of health, effective interservice linkages and communication, and equity-driven and congruent data systems. CONCLUSION: The findings are consistent with other literature exploring access to health care for rural Indigenous Peoples. This review offers a novel approach to summarising literature by situating the themes within the context of equity and rights for Indigenous Peoples. This review also highlighted the need for further research in this area to be conducted in the context of Aotearoa New Zealand.


Assuntos
Doenças Cardiovasculares , Acessibilidade aos Serviços de Saúde , População Rural , Humanos , Acessibilidade aos Serviços de Saúde/organização & administração , Doenças Cardiovasculares/terapia , Doenças Cardiovasculares/etnologia , População Rural/estatística & dados numéricos , Nova Zelândia/epidemiologia , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Povos Indígenas , Serviços de Saúde do Indígena/organização & administração , Serviços de Saúde Rural/organização & administração
19.
Bol. latinoam. Caribe plantas med. aromát ; 23(3): 410-436, mayo 2024. ilus, tab
Artigo em Inglês | LILACS | ID: biblio-1538165

RESUMO

In the indigenous peoples Tu'un savi and Mé'pháá of the mountain region of guerrero, allopathic medicine and traditional herbal medicine are used, due to this, we consider that dialogues of knowledge should be established between the practitioners of both medicines. We collaborated with 46 individuals to discuss the forms of using medicinal species, preparing treatments, and using allopathic medicine. Through semi-structured and in-depthinterviews, 121 plant species were recorded, with which more than 40 diseases are treated, which are distributed in the digestive, muscular, respiratory, and urinary systems:chronic-degenerative and cultural diseases. The dialogue of knowledge between specialists in traditional medicine and allopathic doctors could contribute to the development of their own health project, with which a regional ethnodevelopment plan could be created.


En los pueblos indígenas Tu'un savi y Mé'pháá de la montaña de Guerrero se utiliza la medicina alopática y la medicina tradicional herbolaria, debido a ello, consideramos que deberían establecerse diálogos de saberes entre los practicantes de ambas medicinas. Se trabajó con 46 colaboradores, con los cuales se dialogó acerca de las formas de uso de las especies medicinales, preparación de los tratamientos y utilización de l a medicina alopática. A través de entrevistas semiestructuradas y a profundidad se registraron 121 especies de plantas, con las que se tratan más de 40 enfermedades, las cuales están distribuidas en los sistemas digestivo, respiratorio y urinario; también se atienden enfermedades crónico - degenerativas y culturales. El diálogo de saberes entre especialistas de la medicina tradicional y médicos alópatas podría contribuir a la elaboración de un proyecto de salud propio, con el cual se podría crear un plan de e tnodesarrollo regional


Assuntos
Conhecimentos, Atitudes e Prática em Saúde/etnologia , Medicina Tradicional , Plantas Medicinais , Povos Indígenas , México
20.
Int J Circumpolar Health ; 83(1): 2343144, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38626421

RESUMO

The overincarceration of Indigenous peoples and its impacts on individual and community health is a growing concern across Canada and the United States. Federally run Healing Lodges in Canada are an example of support services for incarcerated and previously incarcerated Indigenous peoples to reintegrate into community and support their healing journey. However, there is a need to synthesise research which investigates these programmes. We report a protocol for a scoping review that is guided by the following research question: What is known about culturally informed programmes and services available to incarcerated and previously incarcerated Indigenous peoples in Canada and the US? This scoping review will follow guidelines published by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. This review will only identify programmes that are guided by Indigenous ways of being and knowing in order to best serve Indigenous communities and our community partners. The results of this review will support the development of programmes that are necessary for understanding and addressing the diverse needs of incarcerated and previously incarcerated Indigenous peoples.


Assuntos
Povos Indígenas , Prisioneiros , Humanos , Estados Unidos , Canadá , Saúde Pública , Revisões Sistemáticas como Assunto , Literatura de Revisão como Assunto
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