Abstract
The variables such as race, skin colour and ethnicity have become intensely discussed in medicine research, as a response to the rising debate over the importance of the ethnic-racial dimension in the scope of health-disease processes. The aim of this study was to identify the European (EUR), African (AFR) and Amerindian (AMR) ancestries on Brazilian health outcomes through a systematic literature review. This study was carried out by searching in three electronic databases, for studies published between 2005 and 2017. A total of 13 papers were eligible. The search identified the following health outcomes: visceral leishmaniosis, malaria, Alzheimer’s disease, neuromyelitis optica, multiple sclerosis, prostate cancer, non-syndromic cleft lip/palate, chronic heart failure, sickle cell disease, primary congenital glaucoma, preterm labour, preterm premature rupture of membranes, systemic lupus erythematosus and type 1 diabetes mellitus. Research paper assessments were guided by the STROBE instrument, and agreements between results were determined by comparing the points attributed by two authors. Increased EUR ancestry was identified from preterm labour (PTL), type 1 diabetes (T1D) and non-syndromic cleft lip with or without cleft palate (NSCL), as well as in patients presenting aggressive prostate cancer prognoses. On the other hand, the highest AFR ancestral component was verified from systemic lupus erythematosus (SLE) and primary congenital glaucoma (PCG) cases, presenting worse prognoses. AMR ancestry may be a protective factor in the development of Alzheimer’s disease (AD). The worst hemodynamic parameters in cases of heart failure (HF) were identified among individuals with greater AMR and AFR ancestry indices.
Highlights
The variables such as race, skin colour and ethnicity have become intensely discussed in medicine research, as a response to the rising debate over the importance of the ethnic-racial dimension in the scope of health-disease processes
This study aimed to carry out a systematic literature review on the EUR, AFR and AMR ancestry components on health outcomes in Brazil, i.e., identifying the three main ancestry components that could contribute to Brazilian people health outcomes
The ideal of building a nation modelled after Europe, throughout the 19th century, made it difficult for Asian workers to immigrate to Brazil
Summary
The variables such as race, skin colour and ethnicity have become intensely discussed in medicine research, as a response to the rising debate over the importance of the ethnic-racial dimension in the scope of health-disease processes. Amerindians (AMR), Europeans (EUR) and Africans (AFR), was historically described by the Brazilian anthropologist Darcy Ribeiro, in “The Brazilian People”[4] This miscegenation process led to sub-populations with differences in the proportion of admixed individuals. The issue of undetected misleading effects is noted when the investigated population is composed of subpopulations presenting several ancestry backgrounds (with different allelic frequencies and risk for disease occurrence). This leads to unequal representation in case and control groups, which may result in false-positive associations during statistical analyses[7,8,9]. It should be noted that, due to the differences in racial categorization methodologies among the selected papers, the authors were not able to summarize, in this recent systematic review, case-by-case disease prevalence estimates according to race/skin colour[17]
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