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巴西一个州在消除疟疾时代的非法采矿活动的一个缩影,该州有土著地区。

A snapshot of a representative Brazilian state of illegal mining in indigenous areas during the era of malaria elimination.

机构信息

Coordenação Geral de Vigilância em Saúde, Secretaria de Estado da Saúde de Roraima, Boa Vista, Brasil.

Programa de Pós-graduação em Biodiversidade e Biotecnologia da Rede BIONORTE, Boa Vista, Brasil.

出版信息

Cad Saude Publica. 2024 Jul 29;40(6):e00224023. doi: 10.1590/0102-311XEN224023. eCollection 2024.

Abstract

Malaria is a public health problem and the cases diagnosed in the capital of Roraima, Brazil, show potential to characterize the burden of the disease in the state. This study aimed to describe the epidemiological, clinical, and laboratory aspects of malaria cases diagnosed in Boa Vista. For this purpose, a descriptive, cross-sectional study was conducted in two health units in the city, with individuals diagnosed and who agreed to respond the questionnaire. Of the total of 206 participants, characterized as men, mixed-race, and young, 96% (198) reported participating in illegal mining activity. Among the group of miners, 66% (131) came from other states of Brazil or other countries. The mines were mainly located in the Yanomami territory in Roraima. Plasmodium vivax infection occurred in 74% (153) of participants. In the miner's group, hospitalizations for severe malaria, previous malaria attacks, and delays in treatment after the onset of symptoms were reported. Although 73% (145) of miners reported knowing how malaria was transmitted, only 54% (107) used mosquito nets or repellents. The use of Artecom and chloroquine by miners is not for the complete treatment but only to relieve symptoms for returning to gold mines, highlighting the importance of molecular surveillance to antimalarial resistance. Indigenous peoples are considered vulnerable to malaria and miners promotes the increase of malaria in Roraima Indigenous Lands. Therefore, access to diagnosis and treatment in Indigenous areas invaded by miners is imperative to confront this disease that ravages Indigenous communities and threatens public health on a large scale to achieve the goal of eliminating malaria in the state.

摘要

疟疾是一个公共卫生问题,在巴西罗赖马州首府诊断出的病例具有阐明该州疾病负担的潜力。本研究旨在描述博阿维斯塔诊断出的疟疾病例的流行病学、临床和实验室方面。为此,在该市的两个卫生单位进行了一项描述性、横断面研究,包括确诊并同意回答问卷的个体。在总共 206 名参与者中,有男性、混血儿和年轻人,96%(198 人)报告参加了非法采矿活动。在矿工群体中,66%(131 人)来自巴西其他州或其他国家。这些矿山主要位于罗赖马的雅诺马米领土。74%(153 人)的参与者感染了间日疟原虫。在矿工群体中,报告了因严重疟疾住院、以前疟疾发作和发病后治疗延迟的情况。尽管 73%(145 人)的矿工报告知道疟疾是如何传播的,但只有 54%(107 人)使用蚊帐或驱虫剂。矿工使用 Artecom 和氯喹并不是为了完成治疗,只是为了缓解症状后返回金矿,这突显了分子监测对抗疟药耐药性的重要性。土著人民被认为易患疟疾,而矿工则促进了罗赖马土著土地上疟疾的增加。因此,必须在被矿工入侵的土著地区提供诊断和治疗,以应对这种肆虐土著社区并对大规模公共卫生构成威胁的疾病,从而实现该州消除疟疾的目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/231a/11290832/e60b09359f25/1678-4464-csp-40-06-EN224023-gf1.jpg

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