Dados do Trabalho

Título

The first year of the COVID-19 pandemic in an indigenous population in Brazil: an epidemiological study

Introdução

Indigenous populations in Brazil experience a disproportionate burden of disease due to geographical and socioeconomic factors and poorer social determinants of health than non-indigenous people. The spread of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in indigenous communities has exposed a failing health system, involving challenges with access to health services, social distancing,
effective communication, and social support.

Objetivo (s)

This cross-sectional observational study that describes the epidemiological data of the first year of the COVID-19 pandemic in the Mato Grosso do Sul State, aimed to demonstrate the differences between indigenous and non-indigenous populations, characterize confirmed cases of COVID-19 according to risk factors related to ethnicity, comorbidities and their evolution and to verify the challenges in facing the disease in Brazil.

Material e Métodos

SIVEP-Gripe and E-SUS-VE, a nationwide surveillance database in Brazil, from March 2020 to March 2021 in Mato Grosso do Sul state, were used to compare survivors and non-survivors from indigenous and nonindigenous populations and the epidemiological incidence curves of these populations.

Resultados e Conclusão

The total number of confirmed cases of COVID-19 was 176,478, including 5,299 indigenous people. Among the indigenous population, 52.5% (confidence interval [CI] 51.2–53.9) were women, 38% (CI 36.7–39.4) were 20–39 years old, 56.7% were diagnosed by rapid antibody tests, 12.3% (CI 95%: 11.5–13.2) had at least one comorbidity, and 5.3% (CI 95%: 4.7–5.9) were hospitalized. In the non-indigenous patients, 56.8% were confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR), 4.4% (CI 95%: 4.3–4.5) had at least one comorbidity, and 8.0% (CI 95%: 7.9–8.2) were hospitalized. Majority of the non-survivors were ≥60 years old (65.1% indigenous vs. 74.1% non-indigenous). The number of indigenous patients who died in a non-hospital setting was more than three times higher (11% vs. 2.9%). Indigenous individuals had a lower proportion of diagnosis by RT-PCR and poorer registration of cases. Among them, deaths were more frequent in younger patients, and they were less likely to be admitted to hospital services. Mass vaccination may have controlled the COVID-19-associated incidence and mortality in this population during the period of increased viral circulation.

Palavras-chave

Health of Indigenous Peoples, Epidemiology, Coronavirus Infections

Agradecimentos

CNPq Nº 401727/2020-3