Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, Brazil.
Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil.
Toxins (Basel). 2023 Mar 3;15(3):194. doi: 10.3390/toxins15030194.
In the Brazilian Amazon, deaths and disabilities from snakebite envenomations (SBEs) are a major and neglected problem for the indigenous population. However, minimal research has been conducted on how indigenous peoples access and utilize the health system for snakebite treatment. A qualitative study was conducted to understand the experiences of health care professionals (HCPs) who provide biomedical care to indigenous peoples with SBEs in the Brazilian Amazon. Focus group discussions (FGDs) were carried out in the context of a three-day training session for HCPs who work for the Indigenous Health Care Subsystem. A total of 56 HCPs participated, 27 in Boa Vista and 29 in Manaus. Thematic analysis resulted in three key findings: Indigenous peoples are amenable to receiving antivenom but not to leaving their villages for hospitals; HCPs require antivenom and additional resources to improve patient care; and HCPs strongly recommend a joint, bicultural approach to SBE treatment. Decentralizing antivenom to local health units addresses the central barriers identified in this study (e.g., resistance to hospitals, transportation). The vast diversity of ethnicities in the Brazilian Amazon will be a challenge, and additional studies should be conducted regarding preparing HCPs to work in intercultural contexts.
在巴西亚马逊地区，蛇咬伤（SBE）导致的死亡和残疾是土著居民面临的一个严重而被忽视的问题。然而，对于土著人民如何获得和利用卫生系统来治疗蛇咬伤，几乎没有进行研究。本研究开展了一项定性研究，以了解为巴西亚马逊地区遭受 SBE 的土著人民提供生物医学护理的卫生保健专业人员（HCP）的经历。在为为土著医疗保健子系统工作的 HCP 进行为期三天的培训课程的背景下，进行了焦点小组讨论（FGD）。共有 56 名 HCP 参加了讨论，其中 27 人来自博阿维斯塔，29 人来自马瑙斯。主题分析得出了三个主要发现：土著人民愿意接受抗蛇毒血清，但不愿意离开村庄去医院；HCP 需要抗蛇毒血清和其他资源来改善患者护理；HCP 强烈建议采用双语联合方法治疗 SBE。将抗蛇毒血清分散到当地卫生单位可以解决本研究中确定的核心障碍（例如，对医院的抵制、交通）。巴西亚马逊地区的种族多样性巨大，这将是一个挑战，应就如何培训 HCP 在跨文化环境中工作开展更多研究。
