Brito E B, Menezes R C, Martins S J, Bastos M G, Sousa A
Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, PA.
Rev Assoc Med Bras (1992). 1996 Jan-Mar;42(1):11-5.
We evaluated the occurrence of low-trait genital infection and cervical epithelial dysplasia in women from a South-american indian tribe in the Brazilian Amazonia.
Cross-sectional study of women older than 10 years from two indian settlements of the Parakanã tribe: Paranatinga and Maroxewara. Demographic data and information about sexual behavior as well as obstetric/gynaecological history were recorded. Two gynecologists examined 80 patients (89.9%), and collected vaginal and cervical specimens of 69 indians for further laboratory analysis, by Gram stain and Papanicolaou method. Fourteen (20.3%) women resulted to be pregnant.
Parakanã women begin sexual activity early, after menarche; they have multiple sexual partners; are multiparous. Some of his partners already had intercourse with women of our society. In Paranatinga, vaginal discharges were a very frequent sign and not age-related, and women presented high frequency of disturbances on lactobacilli flora, greater than among inhabitants of Maroxewara. Pap smears in 91.5% of all patients showed inflammatory pattern. When found an possible etiologic agent (61.3%), in 63.4% it was Gardnerella vaginalis, in 7.3% Trichomonas vaginalis and in 4.9% Candida sp. In 23.2% of smears cythophatic signs related to infection by human papillomavirus were identified. One case had morphological changes compatible with cervical intraepithelial neoplasia grade I, another with CIN II and, in a 48 year old indian, cervical cancer.
Near all women had some grade of cervical disease. Measure HPV-infection prevalence among Parakanã indians with adequate methods may improve our understanding about worldwide occurrence of HPV infections. Established risk factors for cancer of the cervix and sexually transmitted diseases were common in this tribe.
我们评估了巴西亚马逊地区一个南美印第安部落女性低特质生殖器感染和宫颈上皮发育异常的发生情况。
对来自帕拉卡南部落两个印第安定居点（帕拉纳廷加和马罗克塞瓦拉）10岁以上女性进行横断面研究。记录人口统计学数据、性行为信息以及产科/妇科病史。两名妇科医生对80名患者（89.9%）进行了检查，并采集了69名印第安人的阴道和宫颈标本，通过革兰氏染色和巴氏涂片法进行进一步实验室分析。14名（20.3%）女性被证实怀孕。
帕拉卡南女性初潮后很早就开始性活动；她们有多个性伴侣；多产。她们的一些性伴侣已经与我们社会的女性发生过性关系。在帕拉纳廷加，白带异常是非常常见的症状且与年龄无关，女性乳酸杆菌菌群紊乱的频率高于马罗克塞瓦拉的居民。所有患者中91.5%的巴氏涂片显示有炎症表现。当发现可能的病原体时（61.3%），63.4%为阴道加德纳菌，7.3%为阴道毛滴虫，4.9%为念珠菌属。在23.2%的涂片检查中发现了与人类乳头瘤病毒感染相关的细胞病变体征。1例有符合宫颈上皮内瘤变I级的形态学改变，另1例为CIN II级，还有1名48岁的印第安女性患有宫颈癌。
几乎所有女性都有某种程度的宫颈疾病。用适当方法测定帕拉卡南印第安人中HPV感染的患病率可能会增进我们对全球HPV感染发生情况的了解。宫颈癌和性传播疾病的既定危险因素在这个部落很常见。
