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巴西原住民中 COVID-19 大流行背景下的严重急性呼吸综合征(SARS):流行病学和与死亡相关的风险因素。

Severe Acute Respiratory Syndrome (SARS) in the Context of the COVID-19 Pandemic Among Indigenous Peoples of Brazil: Epidemiology and Risk Factors Associated with Death.

机构信息

Medical School of the Federal University of Fronteira Sul, Campus Passo Fundo, Passo Fundo, Brazil.

Post-Graduate Program in Biomedical Sciences, School of Medicine, Federal University of Fronteira Sul, Campus Passo Fundo, Passo Fundo, Brazil.

出版信息

J Racial Ethn Health Disparities. 2024 Aug;11(4):1908-1917. doi: 10.1007/s40615-023-01660-z. Epub 2023 Jun 14.

Abstract

INTRODUCTION

Severe Acute Respiratory Syndrome (SARS) represents a serious public health problem for the indigenous peoples of Brazil, since acute respiratory infections are the main causes of morbidity and mortality in this population.

OBJECTIVE

To assess cases of SARS in Brazilian indigenous peoples in the context of the COVID-19 pandemic, as well as sociodemographic and health factors associated with deaths from SARS in this population.

METHODS

Ecological study carried out based on secondary data from the Brazilian Database for Epidemiological Surveillance of Influenza referring to the Brazilian indigenous population with SARS in 2020. The variables included sociodemographic factors and health conditions. Statistical analyses were carried out considering absolute (n) and relative (%) frequencies and logistic regression with odds ratios (OR), with death as the outcome of interest.

RESULTS

A total of 3062 cases were reported in the analyzed period. Of these, there was a predominance of men (54.6%), adults (41.4%), with comorbidities (52.3%), with low levels of schooling (67.4%) and residents of rural areas (55.8%). Cases and deaths were concentrated in the states of Amazonas and Mato Grosso do Sul, states in the North and Midwest of Brazil. A greater chance of death was observed in elderly indigenous people (OR = 6.29; 95%CI 4.71-8.39), with low levels of schooling (OR = 1.72; 95%CI 1.22-2.28), residents of rural areas (OR = 1.35; 95%CI 1.12-1.62), and with comorbidities (OR = 1.87; 95%CI 1.42-2.46), especially obesity (OR = 2.56; 95%CI 1.07-6.11).

CONCLUSION

The study was able to trace the clinical-epidemiological profile, as well as identify the groups of indigenous people most vulnerable to SARS as a result of COVID-19 and evolution to death in Brazil. The findings show the high impact on the morbidity and mortality of the Brazilian indigenous population exposed to SARS and are relevant for epidemiological health surveillance, since they can guide preventive public policy actions and quality of life measures for this ethnic group in Brazil.

摘要

简介

严重急性呼吸系统综合征(SARS)对巴西原住民构成了严重的公共卫生问题,因为急性呼吸道感染是该人群发病率和死亡率的主要原因。

目的

评估 2020 年 COVID-19 大流行期间巴西原住民中的 SARS 病例,以及与该人群 SARS 死亡相关的社会人口学和健康因素。

方法

基于巴西流感流行病学监测数据库中针对巴西原住民 SARS 的二次数据进行的生态学研究。所包括的变量包括社会人口学因素和健康状况。进行了统计分析,考虑了绝对(n)和相对(%)频率以及具有优势比(OR)的逻辑回归,以死亡为感兴趣的结果。

结果

在所分析的时间段内报告了 3062 例病例。其中,男性(54.6%)、成年人(41.4%)、合并症(52.3%)、受教育程度低(67.4%)和农村地区居民(55.8%)居多。病例和死亡集中在亚马逊州和南马托格罗索州,这两个州位于巴西的北部和中西部。观察到土著老年人死亡的可能性更大(OR=6.29;95%CI 4.71-8.39),受教育程度低(OR=1.72;95%CI 1.22-2.28),居住在农村地区(OR=1.35;95%CI 1.12-1.62),以及合并症(OR=1.87;95%CI 1.42-2.46),尤其是肥胖(OR=2.56;95%CI 1.07-6.11)。

结论

该研究能够描绘出临床流行病学特征,并确定了巴西原住民中因 COVID-19 而最容易感染 SARS 并发展为死亡的人群。这些发现表明,SARS 对巴西原住民的发病率和死亡率有很大的影响,这对于流行病学健康监测具有重要意义,因为它们可以为该族裔在巴西的预防公共政策行动和生活质量措施提供指导。

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