Manaus Metropolitan Region Research Articles

POTENTIALS AND LIMITATIONS OF THE TRACEABILITY PROCESS OF ORGANIC FOOD PRODUCTION

Organic production is one of the driving engines of a large gear, as on the basis of organic production all food is grown sustainably. The organic food production traceability system emerges as a strategic tool to guarantee safe food and environmental dynamics in the use of biodiversity, identifying and exposing the links between spatially distributed structures differentiating places and processes. The study was carried out in the municipality of Rio Preto da Eva, specifically in the São Francisco community in Ramal Cachoeira, as a survey of information on traceability, theoretical methodological procedures were taken as a basis through documentary and bibliographical research. In this specific case, we work with OCS, from the municipality of Rio Preto da Eva, which is located in the metropolitan region of Manaus. OCS's are formal or informal organizations that carry out social control as a way of guaranteeing the quality of organic production through the organization of farmers themselves. Therefore, the data allowed us to confirm the hypothesis that the traceability of organic products can ensure family farmers through reliability to offer safe, quality food and consequently promote a sustainable market.

Impactos das Mudanças da Cobertura do Solo e Aumento dos Gases do Efeito Estufa no Clima da Região Metropolitana de Manaus

Abstract This study analyzed the impact of land use and land cover (LULC) changes and increased in greenhouse gases (GHGs) on surface variables in the climate of the metropolitan region of Manaus (MRM). The numerical experiments were carried out using the BRAMS regional model for the MRM rainy season period and divided into four categories, namely: actual land cover, sensitivity to deforestation and urbanization expansions, sensitivity to increased GHGs, and a combined experiment driven by an extreme scenario. Changes in LULC produced local alterations in the energy and radiation balances and in surface temperature. In addition, the diurnal cycle of the precipitation showed an increase after peak hours over the urban area. In the scenario of increasing GHGs, significant changes in the components of the radiation and energy balances resulted in a positive surface temperature anomaly (∼10 °C) and a negative precipitation anomaly (∼50%). These changes were slightly intensified in the combined experiment. It was found that MRM's climate is more sensitive to an increase in GHGs than to a local change in LULC. Our results reinforce the urgent need to take measures to contain the global increase in GHGs because, in the face of such a scenario, the maintenance of the forest, its ecological processes, and its environmental services would be impossible.

Variables limnológicas asociadas a la presencia de larvas de Anopheles Meigen, 1818 (Diptera: Culicidae) en criaderos de Amazonas, Brasil

The objective of this study was to correlate environmental characteristics (biotic and abiotic) of different breeding site types with the richness and abundance of anophelines in the metropolitan region of Manaus, Brazil. Anopheles larvae and biotic and abiotic parameters were collected in artificial breeding sites, where we demonstrated that the dams presented characteristics of natural environments, with good water quality, shaded areas, and the presence of macrophytes, positively influencing the larval abundance of anophelines. The fish ponds are in the process of transitioning from a natural to an altered environment, followed by breeding sites classified as clay pits (anthropized). Macrophyte richness was higher in dams and fish ponds, being responsible for creating microhabitats for larvae and the structure of breeding sites. Ten anopheline species were identified, totaling 1,186 individuals, with an abundance of An. triannulatus (Neiva & Pinto, 1922), An. albitarsis Lynch-Arribálzaga, 1878, An. nuneztovari Gabaldón, 1940 and An. darlingi Root, 1926. Malaria vectors in the region were present in all collection sites. A good part of the physicochemical parameters were in agreement with the current environmental resolution, mainly in less altered environments. Another strong correlation was observed between anophelines and some limnological parameters, which may be an indicator of the presence of these Culicidae in the environments.

Museums, ethnographic collections and social identity: reflections on the curatorship shared with the sateré mawé in a university museum in the city of Manaus, Amazonas, Brazil

This work presents an experience carried out with the Sateré Mawé people in the identification and qualification of indigenous artifacts seized by the Brazilian Institute of the Environment and Renewable Resources, and which are under the custody of the Amazon Museum belonging to the Federal University of Amazonas. The dialogue between indigenous people and the museum is based on the idea of collaborative museology, centered on the symmetrical relationship in which the relationship between indigenous people and objects identified as belonging to their culture is described. As a methodological resource, six “memory workshops” were held, when the artifacts were presented to indigenous people who described the objects, their uses and names in their own language. We chose to initially outline some aspects and concepts that are mobilized in the research, such as ethnic identity, collaborative museology and the context of museums in Brazil with ethnographic collections. Secondly, we present details of the process for reflection on how identity manifests itself in the experience of collaborative museology with the Sateré-Mawé people in the aforementioned museum. The observation was carried out during the workshops, held within the scope of the Amazon Museum with sateré mawé coming from four communities located in the metropolitan region of Manaus.

Neoliberalism as a Producer of Precariousness and the Scenario of Domestic Workers in Manaus

Objective: To investigate the influences of neoliberalism as an economic and social model in the material conditions and subjectivity of domestic workers in the metropolitan region of Manaus. Theoretical benchmark: domestic work is a historically racialized and precarious profession in Brazil, and this precariousness is intensified by the neoliberal scenario of the global economy of subjectivation. Method: qualitative research of inductive model was conducted with semi-structured interviews and submitted to content analysis for study. Results and conclusion: in the analysis were found factors indicative of the effects of neoliberalism both in the material reality of work and in the subjectivity of domestic workers Implications of research: the research offers new scientific contributions to the theme of domestic work, offering theoretical bases for interventions and public policies that impact this class of workers. Originality/value: the theme of the research demonstrates high social relevance for a greater political understanding of the socioeconomic scenario around domestic workers and their apprehension for future scientific and public policy works.

Tourist-Communicational Ecosystem in Cirandas of Manacapuru – Amazon

This article presents a partial report of a research on the Brazilian Amazon, entitled Ciranda de Manacapuru as a metaphor for the Amazon: signs of the touristic, communicational, and subjective ecosystem of the region. Ciranda de Manacapuru is a popular dance festival that takes place every year in August in the municipality of Manacapuru, located in the Metropolitan Region of Manaus, in the state of Amazonas, in northern Brazil. This is an event promoted by the State and local government with the participation of three ciranda associations: Flor Matizada, Guerreiros Mura, and Tradicional. This festival is considered the largest Festival of Cirandas in the state, attracting around 50,000 tourists every year. During the Covid19 pandemic, the festival was presented by social media platforms (2020 and 2021). In this cultural manifestation of the city, an important sign of local tourism can be seen, considering the various agents involved, which is capable of attracting a differentiated, expressive, and consumer public. In theoretical terms, the research is being developed with an ecosystemic-complex orientation, which has been marking the studies of AMORCOMTUR! – Study Group on Communication, Tourism, Amouroness, and Autopoiesis. The methodological strategy is the Cartography of Knowledge, qualitative, procedural, and multi-methodological, with development in five investigative paths: We-interlaces, Personal Knowledge, Theoretical Knowledge, Production Plant, and Intuitive Research Dimension. The preliminary results indicated the expressive power of the narratives produced in the Cirandas by the various subjects involved, which makes it possible to reflect on the Tourism-Communication Ecosystemic plot that is established, evaluating the interrelationship of the city of Manacapuru and the cultural manifestation of Ciranda as an autopoietic power.

Carbon monoxide profile variability over the Manaus Metropolitan Region and its relations with biomass burning

The present study analyzes the temporal variability of carbon monoxide (CO) over the Manaus Metropolitan Region (MMR) and its relations with nearby fires based on data obtained by the environmental satellite AQUA, for the 2003–2020 period. For this purpose, wavelet transform analyses and wavelet coherence analyses were used. The results show a well-defined seasonal behavior, with an increase and decrease in mean CO concentrations during dry and wet seasons, respectively. Semiannual and annual scales represent around 95 % of CO temporal variability in lower troposphere (500 to 1,000 hPa) and are associated with rains and fires dynamics in the region. In terms of interannual variability, multiple variability scales (1.2–2, 2.5–3 and 4.5–6 years) were observed, which explain around 10–15 % of concentration variability near surface. The results suggest that climatic variations, associated with the tropical Pacific and Atlantic sea surface temperature variations, on these different time scales, affect rain dynamics and, consequently, fires and CO concentration. Specifically, in 2015/16, the combined effect from different variability scales acted to prolong the dry period over the region, which contributed to increase fires and the CO to reach higher values compared to previous years. These results show a new aspect of the importance of evaluating the combined effect of different climate variability scales on CO concentrations in the atmosphere.

Seasonality of fruit production of Euterpe oleracea and E. precatoria açaí palm trees cultivated in the metropolitan region of Manaus (AM)

The off-season period for açaí palm production cause social and economic problems that affect producers and consumers. Two species are used for açaí pulp production, Euterpe oleracea and E. precatoria. These species have some distinct characteristics, including the harvest period. The cultivation of açaí palm is expanding in the metropolitan region of Manaus, state of Amazonas, AM, and there are no studies on the harvest period of these species under cultivated conditions in this region. The objective of this study was to evaluate the reproductive phenophases of the açaí palm E. oleracea and E. precatoria grown in the metropolitan region of Manaus, state of Amazonas and to check the harvest period of these species in this region. The reproductive phenophases were evaluated during 24 consecutive months in 20 plants of each species. E. oleracea emitted a greater number of inflorescences from January to July (76%), during the rainy season, and presented a greater number of mature bunches (56%) from October to December, at the end of the dry season. E. precatoria emitted the highest number of inflorescences (70%) from July to November, during the dry season, and the highest proportion of mature bunches (49%) was observed between May and July, at the end of the rainy season. The species presented different harvest periods, so the cultivation of both can contribute to reducing the off-season period of açaí fruit production in the metropolitan region of Manaus, AM.

Screening of febrile patients with suspected malaria from the Brazilian Amazon for virus infection.

Arthropod-borne viruses (arboviruses) are a significant public health threat, especially in tropical and subtropical regions. More than 150 arboviruses can cause febrile illness following infection in humans. The Brazilian Amazon region has the highest number of arboviruses detected worldwide. In addition to arboviruses, malaria, caused byPlasmodium vivax,is endemic in the Amazon. Patients with malaria and arboviral disease frequently show similar clinical presentation and laboratory findings, making the diagnosis of the cause of the infection challenging. The aim of this study was to evaluate the potential for viral infections in patients with suspected malaria but withoutPlasmodiuminfection in the Brazilian Amazon. We recruited 200 subjects with suspected malaria in Manaus, Brazil. First, we tested for arboviruses in serum samples from 124 of the 200 participants using an arbovirus DNA microarray platform, which did not detect any virus. Then, we mixed the serum samples of the other 76 participants in 10 pools and subjected them to next-generation sequencing. Analysis of the sequencing data revealed the presence of only one arbovirus (Zika virus) in one sample pool. This analysis also detected the presence of primate erythroparvovirus 1andpegivirus C. These results suggest that arboviruses are not the most frequent viral infections in patients with suspected malaria but withoutPlasmodiuminfection in the metropolitan region of Manaus. Implementation of specific viral surveillance tests will help in the early detection of viruses with epidemic potential.

HIV infection increases the risk of acquiring Plasmodium vivax malaria: a 4-year cohort study in the Brazilian Amazon HIV and risk of vivax malaria

Globally, malaria and human immunodeficiency virus (HIV) are both independently associated with a massive burden of disease and death. While their co-infection has been well studied for Plasmodium falciparum, scarce data exist regarding the association of P. vivax and HIV. In this cohort study, we assessed the effect of HIV on the risk of vivax malaria infection and recurrence during a 4-year follow-up period in an endemic area of the Brazilian Amazon. For the purpose of this study, we obtained clinical information from January 2012 to December 2016 from two databases. HIV screening data were acquired from the clinical information system at the tropical hospital Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD). The National Malaria Surveillance database (SIVEP malaria) was utilized to identify malaria infections during a 4-year follow-up period after diagnosis of HIV. Both datasets were combined via data linkage. Between 2012 and 2016, a total of 42,121 people were screened for HIV, with 1569 testing positive (3.7%). Out of all the patients diagnosed with HIV, 198 had at least one episode of P. vivax malaria in the follow-up. In the HIV-negative group, 711 participants had at least one P. vivax malaria episode. When comparing both groups, HIV patients had a 6.48 [(5.37–7.83); P < 0.0001] (adjusted relative risk) greater chance of acquiring P. vivax malaria. Moreover, being of the male gender [ARR = 1.41 (1.17–1.71); P < 0.0001], Amerindian ethnicity [ARR = 2.77 (1.46–5.28); P < 0.0001], and a resident in a municipality of the Metropolitan region of Manaus [ARR = 1.48 (1.02–2.15); P = 0.038] were independent risk factors associated with an increased risk of clinical malaria. Education ≥ 8 years [ARR = 0.41 (0.26–0.64); P < 0.0001] and living in the urban area [ARR = 0.44 (0.24–0.80); P = 0.007] were associated to a lower risk of P. vivax malaria. A total of 28 (14.1%) and 180 (25.3%) recurrences (at least a second clinical malaria episode) were reported in the HIV-positive and HIV-negative groups, respectively. After adjusting for sex and education, HIV-positive status was associated with a tendency towards protection from P. vivax malaria recurrences [ARR = 0.55 (0.27–1.10); P = 0.090]. HIV status was not associated with hospitalizations due to P. vivax malaria. CD4 + counts and viral load were not associated with recurrences of P. vivax malaria. No significant differences were found in the distribution of parasitemia between HIV-negative and HIV-positive P. vivax malaria patients. Our results suggest that HIV-positive status is a risk factor for vivax malaria infection, which represents an additional challenge that should be addressed during elimination efforts.

Lethal and sublethal effects of essential oils fromPiper capitarianumYunck andPiper krukoffiiYunck onPlutella xylostellaL.

Plutella xylostella (L.) is responsible for considerable vegetable crop losses in the metropolitan region of Manaus, Brazil. In recent decades, essential oils have been investigated as an alternative to synthetic insecticides. The genusPiperis widely distributed in Amazonia and essential oils from these plants have insecticidal properties. This study describes the chemical composition of the essential oils fromPiper capiterianumandPiper krukoffiias well as the lethal and sublethal effects onP. xylostella. The phytotoxicity of the oils on the host plant was also evaluated. Globulol was the major constituent of theP. krukoffiioil ando-cymene was the major constituent of theP. capitarianumoil. The oil fromP. capiterianumexhibited greater toxicity to larvae and eggs. This oil also presented greater repellant action, feeding deterrence and mild phytotoxicity to the host plant (Brassicae oleraceae). The findings suggest that this oil can be used in the preparation of a formulated insecticide for the management ofP. xylostellain different development phases. However, further studies are needed to evaluate the effect of this oil on crops under field conditions as well as non-target organisms and determine the cost-benefit ratio of a product formulated withP. capitarianumoil.

Amazon deforestation and urban expansion: Simulating future growth in the Manaus Metropolitan Region, Brazil

• Deforestation dynamics and urban growth differ among municipalities in the Manaus Metropolitan Region. • Simulated deforestation is distributed close to previously deforested areas and roads. • Protected areas are important to contain deforestation and urban expansion in the Amazon. • The size of simulated urban patches increases in areas with a higher deforestation and near the roads.

THE TOURISM ETHNIC SPACE AND ITS SYMBOLIC INTERFACES

This article discusses the touristic ethnic space in an indigenous community located in the metropolitan region of Manaus. The study is based on the ethnic perspective, as a historical construction of the identity of a specific group of people, a social group that has a different way of life from the urban world. The research purpose was to analyze the absolute, relative and relational space of a touristic indigenous community, pointing out the territorialities that were built from the touristic activity. The methodology was based on an exploratory study, and the geographic constituency was the Sahu-Apé community, in which it was possible to identify not only the functional dimension, but also its symbolic dimension within the space formed by a set of unique symbols of the ethnic group, compared to other groups. For Haesbaert (2004), these mastery constitute the identity and establish the ways in which relationships are built in indigenous societies based on their ancestors. As main results, it was found that the identity of the Sateré people is configured in its most important object in the tourist activity, and the physical and symbolic space is the tourist product that has been built over time.

AVAILABILITY AND STORAGE OF HAZARDOUS PRODUCTS IN HOUSEHOLDS IN THE METROPOLITAN REGION OF MANAUS: A POPULATION-BASED SURVEY, 2015.

ABSTRACTObjective: The availability of hazardous products in households increases the risks of poisoning. The present study aimed to assess the frequency and associated factors of the availability and storage of hazardous products in residences in the metropolitan region of Manaus.Methods: Population-based and cross-sectional study conducted in 2015 with adults selected with three-stage probabilistic sampling. Participants were interviewed face-to-face. Prevalence ratio (PR) of the presence of hazardous products (presence of chumbinho [illegal anti-cholinesterase rodenticide], artisanal cleaning products, and unsafe storage of these products and medications) and 95% confidence intervals (95%CI) were calculated with Poisson regression with robust variance, weighted by the complex sampling method adopted.Results: A total of 4,001 participants was included, of which 53.0% (95%CI 51.5-54.6) reported presence of hazardous products in their households, 36.3% (95%CI 34.8-37.8) had unsafe storage, 16.2% (95%CI 15.1-17.4) had artisanal cleaning products, and 8.2% (95%CI 7.4-9.1) had chumbinho. Households with children ≤5 years old had safer storage (PR=0.78; 95%CI 0.71-0.86) and more artisanal products (PR=1.30; 95%CI 1.11-1.51). Presence of artisanal products was higher in lower educational levels (PR=2.20; 95%CI 1.36-3.57) and lower economic classifications (PR=1.63; 95%CI 1.25-2.13).Conclusions: Over half of the households in the metropolitan region of Manaus kept hazardous products; one-third stored them unsafely. Artisanal cleaning products and chumbinho were frequently present. Households with children had safer storage of products, and socioeconomic factors affected the availability of such hazardous products.

Ocorrência e fatores de risco associados à infecção por Corynebacterium pseudotuberculosis na ovinocaprinocultura da região metropolitana de Manaus - AM

Caseous lymphadenitis is one of the main concerns in the health management of sheep and goats and, therefore, this work sought to identify the occurrence of this disease in herds in the metropolitan region of Manaus - AM. Visits were made to seven properties, collecting data through investigative questionnaires, physical examinations on 562 animals and microbiological analysis of the samples. Caseous lymphadenitis was observed in 1.78% (10/562) of the animals evaluated, where five (0.89%) of the animals presented reactive lymph nodes and five (0.89%) presented healing processes suggestive of lymphadenitis. Despite the low prevalence in the region, it was noted that there is a need for the dissemination of good agricultural practices and sanitary management in sheep and goat farming in the region.

Continuity of Primary Care in the Brazilian Amazon: A Cross-Sectional Population-Based Study.

Background:Few studies have evaluated the continuity of primary care in universal health care systems, especially in underserved areas.Methods:This was a cross-sectional study with 4,001 adults (≥18 years old) living in the Manaus Metropolitan Region in 2015. Interviews were conducted in households selected with probabilistic sampling. City and neighborhood variables were collected from databanks. Prevalence ratios (PR) of the continuity of care (defined as using a primary care service and having been previously registered in the Family Health Strategy program) and 95% confidence intervals (CIs) were calculated with multilevel Poisson regression analysis.Results:A total of 20.6% (95%CI 19.4-21.9%) of the participants reported continuity of primary care. Women (PR = 1.38; 95%CI 1.18-1.61), nonwhite individuals (PR = 1.13; 95%CI 1.05-1.21), and poorer people (PR = 1.55; 95%CI 1.19-2.02) had higher levels of continuity, whereas health insurance holders had lower levels of continuity (PR = 0.46; 95%CI 0.34-0.62). Individuals with continuity of care had more physician consultations (PR = 1.06; 95%CI 1.02-1.10), dentist consultations (PR = 1.16; 95%CI 1.05-1.28), fewer depressive (PR = 0.59; 95%CI 0.44-0.79) and anxiety symptoms (PR = 0.64; 95%CI 0.48-0.85), and a higher quality of life (β = 0.033; 95%CI 0.011-0.054) than those without continuity.Conclusions:Continuity of care was attained by two-tenths of the population and the level of continuity was high among socioeconomically disadvantaged people. Good outcomes and health services usage increased with continuity of care.

Detection of Common Deletional of α-Thalassemia 3.7 Kb from Metropolitan Region of Manaus, Amazonas, Brazil.

BackgroundAlpha Thalassemia (α-thal) is a heterogeneous group of hereditary alterations caused by deletions that affect alpha regulatory genes, and the 3.7Kb deletion is the most frequent worldwide. The prevalence ranges from 20% and 35% in Brazil, depending mainly on race, predominant in Afro-descendants.PurposeThe aim was to determine α-thal -α3.7Kb and -α4.2Kb deletions, estimating their frequency in individuals from six regions of Amazonas State.MethodsVolunteers age between 18–59 years old of both genders participated in the study. Blood was collected from March 2014 to September 2017 at the health centers of each participant city. α-thal3.7Kb was performed by GAP-PCR, while α-thal4.2Kb by Multiplex-PCR. The total samples collected from each city were: Manaus (capital), 356 (19.7%); Iranduba 232 (12.8%); Manacapuru, 287 (15.9%); Presidente Figueiredo, 370 (20.5%); Itacoatiara, 301 (16.6%); and Coari, 263 (14.5%).ResultsThe average age among males was 35.3±14.8, while for females, it was 36.7±14.9 years old. Microcytosis (MCV <80fL) was found in 158 individuals (8,46%) and α-thal diagnosed in 143 individuals (7.9%), and all of these individuals carried the 3.7Kb deletion 5.95% in heterozygous and 1.95% in homozygous. α-thal4.2kb was not found in any volunteer. The association analyses to the α-thal3.7kb genotypes were statistically significant for all hematological parameters (p<.001), except serum iron and serum ferritin analyses.ConclusionThis study highlights α-thal 3.7kb deletion as an important public health problem, especially in a population not yet characterized about this disease. Thus, epidemiological studies using molecular tools become relevant in regions where the disease is underestimated, contributing to a better understanding of thalassemia incidence and iron deficiency anemias incidence of the participating cities. We reinforce that future molecular studies in North Region from Brazil can be utilized to describe other genetic anemias as structural hemoglobinopathies that have already proven to be highly prevalent in Brazil.

SEMIÓTICA APLICADA AO ESTUDO DA METROPOLIZAÇÃO DO ESPAÇO NO CONTEXTO DA REGIÃO METROPOLITANA DE MANAUS

A Região Metropolitana de Manaus - RMM é juridicamente estabelecida, porém, no que tange a expressão socioespacial, ainda se encontra em desenvolvimento. O recorte consta da metrópole e a parte sul região metropolitana, principalmente o município de Iranduba. A presente proposta tem o objetivo de entender as dinâmicas internas da RMM por meio do processo de metropolização do espaço associado ao discurso que procura justificá-lo. Trata-se de uma análise geográfica, a partir da semiótica, da estrutura da linguagem, ou melhor, do discurso da metropolização na RMM por parte do Estado. Não obstante, sem olvidar a importância dos consumidores e modeladores do espaço urbano para os processos de extensificação da metrópole. Esta pesquisa, portanto, discute elementos da metropolização do espaço e como ela aparece por meio do discurso, muito evidenciado como um aspecto do moderno tendo como principal agente (na Amazônia Ocidental), o Estado.

Perceived discrimination in health services and associated factors in Manaus Metropolitan Region, Brazil: a cross-sectional population-based study

ABSTRACT Objectives: Discrimination is the differentiated treatment of individuals due to prejudgments. Discriminatory practices in health care result in negative effects on patients’ health. In Brazil, skin color represents the main form of racial discrimination, which may have an impact on the accessibility and quality of health care. The Brazilian Amazon lacks investigations on this topic at the population level. This study aims to estimate the prevalence of perceived discrimination in health services and associated factors in the Manaus Metropolitan Region, state of Amazonas, Brazil. Design: A population-based cross-sectional study was conducted with a probabilistic sample of adults interviewed in 2015. The associated factors were investigated by calculating the prevalence ratio (PR) using Poisson regression with robust variance. Results: A total of 4,001 participants were included. The overall prevalence of perceived discrimination was 12.9% (95% confidence interval [CI]: 11.8–13.9%). When compared to the reference categories, women (PR = 1.43; 95%CI: 1.20–1.70), individuals with brown skin color (Brazilian mixed race; PR = 1.33; 95%CI: 1.04–1.71), people who suffer from hypertension (PR = 1.27;95%CI: 1.03–1.57), and people who frequently used health services (p≤0.03) experienced more discrimination from health professionals. Conclusions: The prevalence of perceived discrimination in health services in Manaus Metropolitan Region is frequent and is associated with ethnic, social and health-related factors. Investments in inclusive public health policies and a better quality of health assistance are required to tackle this problem.

Waiting time and medical consultation length in the Manaus metropolitan region, Brazil: a cross-sectional, population-based study, 2015.

Objective . To assess waiting times and length of medical consultations in the Manaus metropolitan region, Brazil. Methods . This was a cross-sectional study conducted with adults living in the region in 2015. Waiting time for consultation and length of consultation in minutes were reported by the participants. Analysis was performed using Tobit regression and weighted by the sample design. Results . 4,001 individuals were interviewed. Average waiting time was 125.4 minutes (95%CI 120.2;130.5), while consultations lasted an average of 52.5 minutes (95%CI 48.0;57.0). Women, poor people, people with less education, indigenous people, people resident in the state interior, people without health insurance, and individuals seen by gynecologists waited longer for their consultation (p <0.05). Consultation time was shorter for non-White people, those with poor health status and those who had health insurance (p <0.05). Conclusion . On average length of medical consultations was half the waiting time. Social inequalities were observed in these lengths of time.