Snakebite envenomations and access to treatment in communities of two indigenous areas of the Western Brazilian Amazon: A cross-sectional study.


Journal

PLoS neglected tropical diseases
ISSN: 1935-2735
Titre abrégé: PLoS Negl Trop Dis
Pays: United States
ID NLM: 101291488

Informations de publication

Date de publication:
07 2023
Historique:
received: 17 03 2023
accepted: 27 06 2023
revised: 25 07 2023
medline: 26 7 2023
pubmed: 13 7 2023
entrez: 13 7 2023
Statut: epublish

Résumé

The indigenous populations of Brazil present poor health indicators and a disproportionate prevalence and case-fatality rate of neglected tropical diseases, including snakebite envenomations (SBEs). This study aims to estimate access to medical care for SBEs and analyze the barriers that prevent victims from accessing healthcare in indigenous communities in two health districts located in the Western Brazilian Amazon. This cross-sectional study used semi-structured interviews to collect data from individuals who experienced SBEs in the Upper Rio Solimões and Upper Rio Negro indigenous health districts. Of the 187 participants, 164 (87.7%) reported that they had access to healthcare and received assistance in a hospital in the urban area of the municipalities. Frequency was 95.4% in the Upper Rio Solimões SIHD, and 69.6% in the Upper Rio Negro SIHD (P<0.0001). The study found that the availability of indigenous medicine as the only choice in the village was the main reason for not accessing healthcare (75%), followed by a lack of financial resources and means of transportation (28.1%). Four deaths were reported from SBEs, resulting in a case-fatality rate of 2.1%. In the study areas, there are records of SBE patients who did not receive medical attention. Availability of pre-hospital emergency transport using motorboats, a greater number of hospitals and better navigability of the Solimões River and its tributaries would make access easier for indigenous people living in the region of the Upper Solimões River. The implementation of cross-cultural hospital care needs to be considered in order to reduce the resistance of indigenous populations in relation to seeking treatment for SBEs.

Sections du résumé

BACKGROUND
The indigenous populations of Brazil present poor health indicators and a disproportionate prevalence and case-fatality rate of neglected tropical diseases, including snakebite envenomations (SBEs). This study aims to estimate access to medical care for SBEs and analyze the barriers that prevent victims from accessing healthcare in indigenous communities in two health districts located in the Western Brazilian Amazon.
METHODOLOGY/PRINCIPAL FINDINGS
This cross-sectional study used semi-structured interviews to collect data from individuals who experienced SBEs in the Upper Rio Solimões and Upper Rio Negro indigenous health districts. Of the 187 participants, 164 (87.7%) reported that they had access to healthcare and received assistance in a hospital in the urban area of the municipalities. Frequency was 95.4% in the Upper Rio Solimões SIHD, and 69.6% in the Upper Rio Negro SIHD (P<0.0001). The study found that the availability of indigenous medicine as the only choice in the village was the main reason for not accessing healthcare (75%), followed by a lack of financial resources and means of transportation (28.1%). Four deaths were reported from SBEs, resulting in a case-fatality rate of 2.1%.
CONCLUSIONS/SIGNIFICANCE
In the study areas, there are records of SBE patients who did not receive medical attention. Availability of pre-hospital emergency transport using motorboats, a greater number of hospitals and better navigability of the Solimões River and its tributaries would make access easier for indigenous people living in the region of the Upper Solimões River. The implementation of cross-cultural hospital care needs to be considered in order to reduce the resistance of indigenous populations in relation to seeking treatment for SBEs.

Identifiants

pubmed: 37440596
doi: 10.1371/journal.pntd.0011485
pii: PNTD-D-23-00351
pmc: PMC10368234
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0011485

Informations de copyright

Copyright: © 2023 de Farias et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Altair Seabra de Farias (AS)

School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Research Department, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.

Manoel Rodrigues Gomes Filho (MR)

Distrito Sanitário Especial Indígena Alto Rio Solimões, Secretaria Especial de Saúde Indígena, Tabatinga, Brazil.

Macio da Costa Arévalo (M)

Distrito Sanitário Especial Indígena Alto Rio Solimões, Secretaria Especial de Saúde Indígena, Tabatinga, Brazil.

Joseir Saturnino Cristino (JS)

School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Research Department, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.

Franciane Ribeiro Farias (FR)

Centro de Estudos Superiores de Tabatinga, Universidade do Estado do Amazonas, Tabatinga, Brazil.

André Sachett (A)

School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Research Department, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.

Alexandre Vilhena Silva-Neto (AV)

School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Research Department, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.

Fabíola Guimarães de Carvalho (FG)

School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.

Sediel Andrade Ambrosio (SA)

Faculdade de Medicina, Universidade Federal do Amazonas, Manaus, Brazil.

Erica da Silva Carvalho (E)

School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Research Department, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.

Marcus Lacerda (M)

School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Research Department, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.
Instituto Leônidas & Maria Deane, Fiocruz, Manaus, Brazil.

Felipe Murta (F)

School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Research Department, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.

Vinícius Azevedo Machado (VA)

School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.

Fan Hui Wen (FH)

Instituto Butantan, São Paulo, Brazil.

Wuelton Monteiro (W)

School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Research Department, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.

Jacqueline Sachett (J)

School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Research Department, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.

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Classifications MeSH