Abstract
BackgroundWarao Amerindians, who inhabit the Orinoco Delta, are the second largest indigenous group in Venezuela. High Warao general mortality rates were mentioned in a limited study 21 years ago. However, there have been no comprehensive studies addressing child survival across the entire population.ObjectivesTo determine the Child Survival-Index (CSI) (ratio: still-living children/total-live births) in the Warao population, the principal causes of childhood death and the socio-demographic factors associated with childhood deaths.MethodsWe conducted a cross-sectional epidemiological survey of 688 women from 97 communities in 7 different subregions of the Orinoco Delta. Data collected included socio-demographic characteristics and the reproductive history of each woman surveyed. The multidimensional poverty index (MPI) was used to classify the households as deprived across the three dimensions of the Human Development Index. Multivariable linear regression and Generalized Linear Model Procedures were used to identify socioeconomic and environmental characteristics statistically associated with the CSI.FindingsThe average CSI was 73.8% ±26. The two most common causes of death were gastroenteritis/diarrhea (63%) and acute respiratory tract Infection/pneumonia (18%). Deaths in children under five years accounted for 97.3% of childhood deaths, with 54% occurring in the neonatal period or first year of life. Most of the women (95.5%) were classified as multidimensionally poor. The general MPI in the sample was 0.56. CSI was negatively correlated with MPI, maternal age, residence in a traditional dwelling and profession of the head of household other than nurse or teacher.ConclusionsThe Warao have a low CSI which is correlated with MPI and maternal age. Infectious diseases are responsible for 85% of childhood deaths. The low socioeconomic development, lack of infrastructure and geographic and cultural isolation suggest that an integrated approach is urgently needed to improve the child survival and overall health of the Warao Amerindians.
Highlights
According to last official Venezuelan Census (2001), the Warao people are the second largest Amerindian group in Venezuela [1]. They live mainly in the Orinoco River Delta; a fan of alluvial deposits within the coastal plain of eastern Venezuela subdivided by networks of fluvial and tidal channels [2], which is divided into three major geographical regions: upper (UOD), intermediate (IOD) and lower delta (LOD) [3]
The objectives of the present study were to: 1) measure the child survival-index (CSI); 2) determine causes of child deaths; and 3) evaluate the socio-demographic factors associated with childhood deaths
In our statistical models we found many variables that were individually associated with a lower Child Survival-Index (CSI), but when considered together in an additive model, the only highly significant associations were with: 1) multidimensional poverty index (MPI); 2) maternal age; and 3) traditional home; with borderline associations for profession of the head of the household other than nurse or teacher, parity and lack of a primary school in the village (Table 6)
Summary
According to last official Venezuelan Census (2001), the Warao people are the second largest Amerindian group in Venezuela [1]. They live mainly in the Orinoco River Delta; a fan of alluvial deposits within the coastal plain of eastern Venezuela subdivided by networks of fluvial and tidal channels [2], which is divided into three major geographical regions: upper (UOD), intermediate (IOD) and lower delta (LOD) [3]. Objectives: To determine the Child Survival-Index (CSI) (ratio: still-living children/total-live births) in the Warao population, the principal causes of childhood death and the socio-demographic factors associated with childhood deaths. The low socioeconomic development, lack of infrastructure and geographic and cultural isolation suggest that an integrated approach is urgently needed to improve the child survival and overall health of the Warao Amerindians
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