title: Tuberculosis in indigenous children in the Brazilian Amazon.
abstract: OBJECTIVE
  Assess the epidemiological aspects of tuberculosis in Brazilian indigenous children and actions to control it.
  
  
  METHODS
  An epidemiological study was performed with 356 children from 0 to 14 years of age in Rondônia State, Amazon, Brazil, during the period 1997-2006. Cases of TB reported to the Notifiable Diseases Surveillance System were divided into indigenous and non-indigenous categories and analyzed according to sex, age group, place of residence, clinical form, diagnostic tests and treatment outcome. A descriptive analysis of cases and hypothesis test (χ²) was carried out to verify if there were differences in the proportions of illness between the groups investigated.
  
  
  RESULTS
  A total of 356 TB cases were identified (125 indigenous, 231 non-indigenous) of which 51.4% of the cases were in males. In the indigenous group, 60.8% of the cases presented in children aged 0-4 years old. The incidence mean was much higher among indigenous; in 2001, 1,047.9 cases/100,000 inhabitants were reported in children aged < 5 years. Pulmonary TB was reported in more than 80% of the cases, and in both groups over 70% of the cases were cured. Cultures and histopathological exams were performed on only 10% of the patients. There were 3 cases of TB/HIV co-infection in the non-indigenous group and none in the indigenous group. The case detection rate was classified as insufficient or fair in more than 80% of the indigenous population notifications, revealing that most of the diagnoses were performed based on chest x-ray.
  
  
  CONCLUSIONS
  The approach used in this study proved useful in demonstrating inequalities in health between indigenous and non-indigenous populations and was superior to the conventional analyses performed by the surveillance services, drawing attention to the need to improve childhood TB diagnosis among the indigenous population.
authors.affiliation: Programa de Epidemiologia em Saúde Pública, Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil. gavascarol@gmail.com
authors.forename: Caroline
authors.initials: C
authors.lastname: Gava
authors.forename: Jocieli
authors.initials: J
authors.lastname: Malacarne
authors.forename: Diana Patrícia Giraldo
authors.initials: DP
authors.lastname: Rios
authors.forename: Clemax Couto
authors.initials: CC
authors.lastname: Sant'Anna
authors.forename: Luiz Antônio Bastos
authors.initials: LA
authors.lastname: Camacho
authors.forename: Paulo Cesar
authors.initials: PC
authors.lastname: Basta
mesh_terms: D000293:Adolescent; D001938:Brazil / Q000453:epidemiology / Q000208:ethnology; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology; D018563:Disease Notification; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007199:Indians, South American / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000208:ethnology