Abstract
Studies on hospital morbidity among Brazilian indigenous peoples are relatively recent, show limited coverage, and lack data sources capable of generating specific indicators according to ethnic group. The current study describes hospital morbidity in the indigenous population living in 83 Guarani villages in Southern and Southeastern Brazil (N=6,483), based on primary data obtained from a hospital admissions surveillance system implemented in 2007-2008, specifically for a case-control study on acute respiratory infections (ARI) in Guarani children. During the study period there were 666 hospitalizations in a total of 497 individuals, the majority under 5 years of age (71.9%). Respiratory illnesses were the main causes of hospitalization (64.6%), especially in children (<5 years: 77.6%; <1 year: 83.4%) and exceeded the proportions of hospital admissions from these causes in other indigenous groups. The overall hospitalization rate (per 100 person-years) was 8.8, or 71.4 under 1 year and 21.0 from 1 to 4 years of age. The ARI hospitalization rate (5.3) was 6.5 and 2.0 times higher than for diarrhea and other causes, respectively, while in children under 5 years of age (ARI=23.7) these differences were 7.4 and 5.4 times, respectively. The standardized Guarani hospitalization rate exceeded the standardized rates for the South and Southeast of Brazil by 40% and 210%, respectively. Hospitalization for primary care sensitive conditions and the high ARI rates indicate the need for studies to understand the epidemiology of ARI and investments to upgrade primary health care for the Guarani.
Highlights
Studies on hospital morbidity represent important tools for understanding the epidemiological profile of population groups, since they contribute to the evaluation of the severity of diseases, surveillance and control of diseases, analysis of access to and utilization of health services, and health planning[1,2,3]
It becomes obvious that studies on hospital morbidity in indigenous peoples lack adequate sources for description, and that adapted data collection strategies are necessary to determine the profile of indigenous hospitalizations in each specific case[4,5,6]
In December 2007 there were 6,483 indigenous people living in the 83 villages, and during the study period there were 780 hospitalizations of 608 Guarani individuals
Summary
Studies on hospital morbidity represent important tools for understanding the epidemiological profile of population groups, since they contribute to the evaluation of the severity of diseases, surveillance and control of diseases, analysis of access to and utilization of health services, and health planning[1,2,3]. This article describes hospital morbidity in the Guarani population living in 83 villages, based on primary data obtained from an indigenous hospital admissions surveillance system implemented for a case-control study on etiological factors in acute respiratory infections (ARI) in Guarani children hospitalized in Southern and Southeastern Brazil. Based on these indicators, the leading causes of hospitalization were identified, as well as the segments of the Guarani population most vulnerable to hospitalization. The indicators were compared to those for the regions of Brazil (after rates standardization by the direct method, using the 2006 Brazilian population as the reference) and those produced in other studies focusing on indigenous and nonindigenous Brazilian populations
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