Mem Inst Oswaldo Cruz, Rio de Janeiro, 112(7) July 2017
Prevalence of tuberculosis respiratory symptoms and associated factors in the indigenous populations of Paraguay (2012)
1Ministry of Public Health and Social Welfare of Paraguay, Tuberculosis Control Program, Asunción, Paraguay
2Universidad Nacional de Asunción, Facultad de Ciencias Médicas, Asunción, Paraguay
3Facultad Latinoamericana de Ciencias Sociales, Department of International Relations, Buenos Aires, Argentina
4Ministry of Public Health and Social Welfare of Paraguay, Central Public Health Laboratory, Asunción, Paraguay
5Ministry of Public Health and Social Welfare of Paraguay, Department of Statistics of the Tuberculosis Control Program, Asunción, Paraguay
6Fundação Oswaldo Cruz-Fiocruz, Escola Nacional de Saúde Pública, Departamento de Epidemiologia e Métodos Quantitativos, Rio de Janeiro, RJ, Brasil
7Universidade do Estado do Rio de Janeiro, Instituto de Medicina Social, Departamento de Epidemiologia, Rio de Janeiro, RJ, Brasil
BACKGROUND The prevalence of respiratory symptoms and confirmed tuberculosis (TB) among indigenous groups in Paraguay is unknown.
METHODS This study assessed the prevalence of respiratory symptoms, confirmed pulmonary TB, and associated socio-economic factors among indigenous Paraguayan populations. Indigenous persons residing in selected communities were included in the study. A total of 24,352 participants were interviewed at home between October and December 2012. Respiratory symptomatic individuals were defined as those with respiratory symptoms of TB. A hierarchical Poisson regression analysis was performed with four levels: individual characteristics, living conditions and environmental characteristics, source of food, and type of nutrition.
FINDINGS In this study, 1,383 participants had respiratory symptoms (5.7%), but only 10 had culture-confirmed TB (41/100,000 inhabitants). The small number of cases did not allow evaluation of the risk factors for TB. Age older than 37 years was associated with a two-fold increased risk of symptoms. Female sex; family history of TB; type of housing; home heating; a lack of hunting, fishing, or purchasing food; and a lack of vegetable consumption were also associated with the presence of symptoms. A lack of cereal consumption had a protective effect. Members of the Ayoreo or Manjui ethnic groups had a three-fold increased risk of symptoms.
MAIN CONCLUSION Individual characteristics, dietary habits, and belonging to specific ethnic groups were associated with respiratory symptoms.