Instituto Leônidas e Maria Deane, Fiocruz Amazônia, Manaus, Amazonas, Brazil
Instituto Leônidas e Maria Deane, Fiocruz Amazônia, Manaus, Amazonas, Brazil; and Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
Rural Remote Health. 2023 Nov;23(4):8249. doi: 10.22605/RRH8249. Epub 2023 Nov 16.
Considering the scarcity of information on the assessment of chronic diseases in traditional Amazonian populations, as well as public health policies focused on their specificities, this study aimed to estimate the prevalence of at least one of the chronic diseases (systemic arterial hypertension (SAH) or diabetes mellitus (DM)) and their concomitant occurrence in a rural riverside population of the Amazon, and determine the associated factors.
A household-based cross-sectional survey was conducted with a sample of adults and elderly people living in rural riverside locations along the left bank of the Negro River, in the municipality of Manaus, Amazonas, Brazil. The outcomes evaluated were the presence of at least one of the evaluated chronic diseases and the concomitant occurrence, based on the self-reported medical diagnosis of SAH and DM. Analysis of associated factors (sociodemographic, behavioral, and access to health services variables) was performed by Poisson regression with robust variance.
The sample consisted of 495 individuals (young adults (n=257; 51.9%), middle-aged (n=132; 26.7%), and elderly (n=106; 21.4%)), of whom 51.5% were women (n=255), mean age 43.3±17.1 years. The monthly household income was on average R$1100±902 (A$345±283). The diagnosis of any chronic disease was reported by 18.8% of the sample, with a preponderance of SAH (17.4%). The occurrence of at least one of the chronic diseases was associated with higher average age and worse health self-assessment. Regarding concomitant occurrence of SAH and DM, prevalent in 4.4% of the sample, the same associations were observed.
The data for the occurrence of chronic diseases in the studied Amazon rural riverside populations are worrying, because these people live in areas of socioeconomic vulnerability, with a lack of basic sanitation infrastructure, difficult geographic access, and limited access to health care. Health policies fail to recognize the specificities of these populations, which implies deficiencies in the provision of necessary regular care. The findings also reinforce the need to strengthen health promotion and chronic disease prevention strategies in the context of primary care.
考虑到关于传统亚马逊人群中慢性疾病评估的信息稀缺，以及公共卫生政策侧重于其特殊性，本研究旨在评估至少有一种慢性疾病（系统性动脉高血压（SAH）或糖尿病（DM））的流行情况及其在亚马逊河畔农村人口中的并发情况，并确定相关因素。
对居住在巴西亚马逊州马瑙斯市左岸内格罗河沿岸农村地区的成年人和老年人进行了一项基于家庭的横断面调查。评估的结果是存在至少一种评估的慢性疾病和并发疾病，基于自我报告的 SAH 和 DM 的医学诊断。通过泊松回归进行关联因素（社会人口学、行为和获得卫生服务变量）分析，并采用稳健方差。
样本包括 495 人（年轻人（n=257；51.9%）、中年人（n=132；26.7%）和老年人（n=106；21.4%）），其中 51.5%为女性（n=255），平均年龄为 43.3±17.1 岁。家庭月收入平均为 R$1100±902（A$345±283）。样本中有 18.8%报告患有任何慢性疾病，其中以 SAH（17.4%）为主。至少有一种慢性疾病的发生与较高的平均年龄和较差的自我健康评估有关。关于 SAH 和 DM 的并发，在样本中发生率为 4.4%，观察到相同的关联。
在所研究的亚马逊河畔农村人群中，慢性疾病的发生数据令人担忧，因为这些人生活在社会经济脆弱的地区，缺乏基本的卫生基础设施，地理位置难以到达，并且获得医疗保健的机会有限。卫生政策未能认识到这些人群的特殊性，这意味着在提供必要的常规护理方面存在缺陷。研究结果还强调了在初级保健背景下加强健康促进和慢性病预防策略的必要性。
