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SETTING: Suruí Indians, Amazonia, Brazil. OBJECTIVE: To estimate the prevalence and the annual risk of infection (ARI) of tuberculosis (TB) in an indigenous population in Brazil. METHODS: We applied a method to estimate the prevalence of TB infection in populations with high bacille Calmette-Guérin (BCG) vaccine coverage. The method consisted of comparing levels of skin test reactivity in individuals tested with purified protein derivative (PPD) before and after stimulation with intradermal BCG. Fieldwork was carried out among the Suruí Indians (n = 993) in two phases, 3 months apart. RESULTS: A total of 645 subjects were tested. In pre-BCG revaccination, tuberculin skin test (TST) indurations averaged 5.9 mm (33.5% > or =10 mm). In post-BCG revaccination TST, indurations averaged 9.4 mm (48.7% > or =10 mm). Conversion from non-reactor to reactor was 54.4%. The ARI ranged from 1.2% to 2.2%. In the logistic regression, age and history of TB were the strongest independent predictors of TB infection. BCG scar and the number of individuals per house were also associated with infection. CONCLUSION: Tuberculous transmission is very high in the Suruí, surpassing the ARI reported for Brazil (0.6%). The epidemiology of TB in this indigenous population is related to unfavourable social and economic conditions, as well as to deficient health care services.

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This paper reports the results of a longitudinal study of malaria incidence (1998-2002) among the Pakaanóva (Wari') Indians, Brazilian southwest Amazon region, based on data routinely gathered by Brazilian National Health Foundation outposts network in conjunction with the Indian health service. Malaria is present yearlong in the Pakaanóva. Statistically significant differences between seasons or months were not noticed. A total of 1933 cases of malaria were diagnosed in the Pakaanóva during this period. The P. vivax / P. falciparum ratio was 3.4. P. vivax accounted for 76.5% of the cases. Infections with P. malariae were not recorded. Incidence rates did not differ by sex. Most malaria cases were reported in children < 10 years old (45%). About one fourth of all cases were diagnosed on women 10-40 years old. An entomological survey carried out at two Pakaanóva villages yielded a total of 3.232 specimens of anophelines. Anopheles darlingi predominated (94.4%). Most specimens were captured outdoors and peak activity hours were noted at early evening and just before sunrise. It was observed that Pakaanóva cultural practices may facilitate outdoor exposure of individuals of both sexes and all age groups during peak hours of mosquito activities (e.g., coming to the river early in the morning for bathing or to draw water, fishing, engaging in hunting camps, etc). In a context in which anophelines are ubiquitous and predominantly exophilic, and humans of both sexes and all ages are prone to outdoor activities during peak mosquito activity hours, malaria is likely to remain endemic in the Pakaanóva, thus requiring the development of alternative control strategies that are culturally and ecologically sensitive.

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OBJECTIVE: To investigate the characteristics of tuberculin skin test reactivity in the Pakaanóva Indians, in Amazonia, Brazil, after revaccination of all study participants with bacille Calmette-Guerin (BCG). METHODS: The investigation was designed as a post-BCG vaccination purified protein derivative (PPD) survey. Data included PPD readings, age, sex, nutritional status, place of residence, previous tuberculosis, physical examinations and BCG status. Bivariate and multivariate logistic regression analyses were conducted. RESULTS: About 90% (n = 505) of the total population participated. One third (32.1%) of the subjects presented induration > or = 10 mm at 72 h. Induration sizes showed weak linear correlation with age; differences between sexes were not observed. Skin reaction was not associated with nutritional status. Individuals with a history of tuberculosis were six times more likely to test positive. History of tuberculosis, age, and previous BCG vaccination were significantly associated with PPD reactivity in the multivariate analyses. CONCLUSION: The Pakaanóva showed a high proportion (58.4%) of non-reactors, even with a recent BCG booster. Sex differences in PPD reactivity were either not present or could not be demonstrated. The association between age and PPD reactivity resembles that observed in other Amazonian populations. The authors discuss the potential of PPD testing as a screening tool to enhance tuberculosis detection, especially in indigenous populations in Amazonia with limited access to health services.

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Until now, Pthirus pubis infestation in ancient human populations had only been recorded in the Old World. We found crab lice on South American mummified bodies from the Atacama Desert region. Crab louse eggs were found attached to the pubic hairs of a 2,000-yr-old Chilean mummy. Well-preserved adults were found in sediment and clothing from a Peruvian mummy dated 1,000 yr ago. Paleoparasitological evidence expands the knowledge of the distribution of this ectoparasite in ancient populations. As with many other parasites, pubic lice recorded in Andean populations show the antiquity of this parasite in the New World. It is likely that P. pubis entered the continent with early human migration to the New World.

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OBJECTIVE: To study blood pressure (BP) levels in the Xavánte Indians of Central Brazil. METHODS: 93 subjects > or = 15 years old were included. Systolic (SBP) and diastolic (DBP) blood pressure readings were taken to the nearest mm Hg at Korotkoff phases 1 and 5 using a mercury sphygmomanometer. Height and weight measurements were taken, as well as general information on demographic, dietary, and social factors, including use of tobacco and alcohol. RESULTS: 5.3% of the adult men and 7.7% of the adult women (> or = 18 years old) were classified as hypertensive (SBP > or = 140 mm Hg and/or DBP > or = 90 mm Hg). No patients were classified as stage 3 hypertensive (SBP > or = 180 mm Hg or DBP > or = 110 mm Hg). Men had higher mean body weight and height than women. There was no major difference in mean BMI (body mass index) for men and women. SBP showed a positive and statistically significant correlation with age in both men (P = .056) and women (P = .040). Among men, DBP showed a negative correlation with height (P = .032). Among women, weight and BMI showed a positive correlation with DBP (P = .013 and P = .005, respectively). Diastolic pressure did not show statistically significant correlation with age for either sex (P>.05). CONCLUSION: The prevalence of hypertension has increased among the Xavánte over the years, which is probably related to behavioral, social, and economic alterations deriving from increased interaction with Brazilian national society.

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Tuberculosis persists as a serious public health problem in Brazil. Prevalence rates are alarming in certain social groups, including indigenous peoples. This article presents an epidemiological analysis of records in the Rondonia State Tuberculosis Control Program, identifying the disease's profile among indigenous groups, which are socially more vulnerable and have different issues involved in controlling the disease. The study includes a descriptive statistical and multivariate multinomial analysis of cases reported in 1992 and from 1994 to 1998, attempting to identify factors associated with tuberculosis-related deaths, treatment drop-out, and missing data. Associations were identified between variables related to the disease, to the health service, and to treatment results. There is evidence that the indigenous populations in Rondonia have an increased risk of acquiring and dying from tuberculosis as compared to other residents of the State. Attention is called to the need for prevention and control measures specifically tailored to the reality of indigenous peoples.

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This study presents the results of an oral health epidemiological survey conducted in 1997, based on WHO criteria, in the Xavánte indigenous community of Pimentel Barbosa (or Etéñitépa), Mato Grosso State, Central Brazil. The study included 228 individuals (85% of the population) over two years of age. In about half the sample, the DMF index was less than 2, and in the 12-14-year age bracket it was 3.7. The low frequency of fillings in permanent and deciduous teeth suggests limited access to dental care services. Despite the number of sextants with bleeding and tartar, no cases of severe periodontal disease were detected (CPITN). In the community, comparison of the results of this survey with two previous surveys (1962 and 1991) showed a deterioration in oral health conditions over time and alterations in the occlusal pattern (increase in Angle class II and III). Dietary changes due to environmental and socioeconomic alterations resulting from interaction with the surrounding society, along with the lack of preventive programs, are among the causes of this deterioration in oral health among the Xavánte.

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Five low-density lipoprotein receptor gene (LDLR) restriction fragment length polymorphisms (RFLPs: TaqI, intron 4; HincII, exon 12; AvaII, exon 13; MspI and NcoI, exon 18) were investigated in 131 individuals from five Brazilian Indian tribes. All markers were polymorphic in this ethnic group. In the whole sample of Amerindians, 13 (41%) of the 32 expected haplotypes were identified, but only three were shared by all tribes. The Xavante, Suruí, Zoró, and Gavião tribes, who had been studied for anthropometry, were grouped according to their genotypes, and the corresponding mean values were examined. Significant associations were observed between HincII *H-, AvaII *A+, MspI *M-, and NcoI *N+ and the body mass index (BMI), triceps and subscapular skinfolds, and the arm fat index (AFI). Haplotypes were derived for these four RFLPs, and (*H-/*A+/*M-/*N+) haplotype carriers were compared with noncarriers of this haplotype with equally significant results for the three parameters (BMI, P=0.021; skinfold thickness, P<0.001; AFI, P=0.005). These results suggest that the LDLR gene has some influence over adipose tissue deposition.

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The apolipoprotein E (APOE) polymorphism was investigated in 186 individuals from six South American Indian tribes, and the results integrated with those previously presented for this ethnic group. The three APOE alleles commonly reported in other populations were also observed in South Amerindians with a highly heterogeneous distribution. As in other populations, APOE*3 was the most common allele (51-98%) followed by APOE*4 (2-47%). These two isoforms were identified in all tribes, but APOE*2 was observed among the Wai Wai (2%) and Mataco (4%) only. No previous indications of inter-ethnic admixture were observed among the Wai Wai, but the introduction of this allele among the Mataco through non-Indian sources cannot be excluded.

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This paper presents an assessment of enamel defects (hypoplasias) in the permanent anterior teeth of three Tupí-Mondé-speaking groups from the Brazilian Amazonia: the Gavião, Suruí, and Zoró. These are native societies that experienced the onset of permanent contact with Brazilian national society in different periods of the 20th century. Tupí-Mondé dentition is highly hypoplastic, which is possibly related to exposure to adverse health and nutritional conditions. Data for the Gavião, Suruí, and Zoró are in agreement with results from other populations that show that certain teeth, the maxillary central incisors and the mandibular canines in particular, tend to be more hypoplastic. Although all types of teeth show hypoplasia concentrations at some enamel zones, there is substantial intertooth variation in the age at which peaks occur. It is argued that hypoplasia concentrations at certain ages are unlikely to be related to postweaning stresses for the Tupí-Mondé. Statistically significant associations between presence of enamel defects and deficits in physical growth (height-for-age) were detected in children 7-11 years of age. Diachronic assessment of enamel defects, which rested upon the potential of enamel as "memory" of past periods of systemic physiological perturbation, allowed us to unravel aspects related to the dynamics of Tupí-Mondé life during the 20th century. Frequencies of enamel zones with defects peaked during the contact years of each of the Tupí-Mondé groups, attesting to the extreme social and biological hardships that characterized the contact experiences of these native societies with Brazilian national society.

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This study begins by briefly situating the development of indexing procedures in the scientific literature, dating to the latter half of the 19th century. Next, taking public health in Latin America as its reference, it analyzes the current use of indexing for the evaluation of scientific production, and thus that of scientific periodicals. The argument is that for various reasons, international indexing should not be used as the only parameter for evaluating the impact of Latin American scientific production in public health. Criteria other than impact indices should be developed to promote a broader understanding of the dynamics of scientific production in the Latin America public health field.

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A sample of 417 individuals belonging to three Tupi-Mondé-speaking tribes (Gavião, Surui, Zoró) were variously studied in relation to 26 genetic protein systems. Previous investigations performed among the Surui in relation to some of these systems were confirmed. The three groups do not depart markedly from the genetic pattern already established for South American Indians and show low inter-ethnic admixture. When these results are combined with those from 10 other Tupi tribes, two clear geographic groupings (southeastern and northwestern) can be discerned. Using different methods to evaluate the same genetic distance matrices, different patterns of association between the Tupi-Mondé populations were obtained. The populations are probably too similar among themselves, blurring finer relationships. Am. J. Hum. Biol. 10:711-722, 1998. © 1998 Wiley-Liss, Inc.

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A total of 94 individuals from the Xavante village of Rio das Mortes were variously studied in relation to 28 protein genetic systems. No variation was observed for 15 of them, in accordance with previous studies. Of the remaining 13, four (Rh, Duffy, acid phosphatase, and GC) showed significant departures from the averages obtained in 32 other South American Indian populations. If studies performed in the 1960s are considered, there is indication that no significant changes in this village's gene pool has occurred in the last 30 years. Comparison with two other Xavante populations included nine systems with variation, and for three of them (MNSs, Rh, and Duffy) significant differences were found. Genetically the Rio das Mortes are closer to the São Marcos than to the Simões Lopes Xavantes. A dendrogram considering 25 genetic systems and 33 South American Indian populations was constructed. There the Xavante were grouped together, in two neighboring clusters, with three other tribes who speak Ge languages, But these clusters also present populations who speak other languages, and the reproducibility of the tree is low. South American Indians, at least with this set of markers, do not seem to be clearly classified into defined subgroups.

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The first 360 base pairs of the mitochondrial DNA (mtDNA) major noncoding region from 82 individuals affiliated with the Brazilian Xavante, Zoró and Gavião tribes were sequenced. A total of 14 different lineages were observed, the largest number (8) being found among the Zoró. The latter share five lineages with the Gavião (who are their neighbors and are culturally similar to them), but only one with the Xavante. The lineages can be grouped into four clusters, previously identified by other authors. The 9 base pair deletion characteristic of Asian and Pacific populations occurs in 32% of the individuals, whose mtDNA was classified in five lineages, all grouped in one of the four clusters. Nucleotide diversity, as evaluated by three indices, are not much different from those observed in Indians from Central and North America, despite the fact that the Xavante consistently show lower numbers. These results do not confirm previous generalizations about the genetic diversity of Amerindians, and the need for additional studies in this system is stressed. © 1996 Wiley-Liss, Inc.

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The genetic variability of butyrylcholinesterase, determined by the BCHE and CHE2 loci, was examined in nine Brazilian Indian groups. In addition, a search for the presence of the BCHE*F allele was also performed in eight other Brazilian Indian samples and in five admixed (black-Indian-white) rural Amazonian communities previously studied for the CHE2 locus and the BCHE*A allele. In the Indian populations the frequency of the BCHE*F allele varied from 0 to 7.1% +/- 3.4 and the frequency of the CHE2 C5+ phenotype ranged from 1.4% +/- 1.4 to 45.9% +/- 3.8. This study seems to be the first to report the presence of the BCHE*F allele in native Americans. The BCHE*A allele appeared in one Indian group (1.4% +/- 1.0), and we suggest that its existence in this tribe and in other native Americans can be explained by gene flow from white populations. Gene flow may also be the reason for the occurrence of the BCHE*F allele in Brazilian Indians, whereas the CHE2*C5+ allele may have been present in the paleo-Indians. The distributions of both the BCHE*F allele and the CHE2 C5+ phenotype in Brazilian Indians seem to be the result of the action of random genetic drift.

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BACKGROUND: Fogo selvagem (FS) is an autoimmune disease that is endemic in certain regions of Brazil and appears to be precipitated by an environmental factor. OBJECTIVE: Our purpose was to confirm the occurrence and prevalence of FS in a population of Xavante Indians living in an endemic region of central Brazil. METHODS: Clinical, anthropologic, and immunologic studies were carried out in patients and in normal inhabitants of the Pimentel Barbosa Indian Reservation, Mato Grosso, Brazil. RESULTS: FS was identified and confirmed in 10 patients from a patient pool of 295 with various skin diseases. The Xavante settlement has a total population of 746. Anti-desmoglein 1 autoantibodies were detected in all patients with FS and were absent from more than 300 serum samples collected from randomly selected unaffected persons. CONCLUSION: FS is strongly linked to outdoor activities and is largely restricted to immunogenetically predisposed persons. FS appears to have been endemic in certain regions of South America for several centuries.

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