title: Factors associated with pneumonia in Yanomami children hospitalized for Ambulatory Care sensitive conditions in the north of Brazil.
abstract: In developing countries, pneumonia is the leading cause of sickness and mortality in childhood, especially among vulnerable groups. The scope of this study was to analyze the factors associated with pneumonia in Yanomami children hospitalized for Ambulatory Care Sensitive Conditions (ACSC). Hospital admissions were divided into two groups: i) pneumonia; and ii) other causes, according to the Brazilian ACSC list. Adjusted hospitalization rates were estimated and unconditional logistic regression was used to analyze factors associated with pneumonia. Over 90% of the registered cases were considered ACSC. The adjusted rate of ACSC was 18.6/1000. The odds ratio of hospitalization for pneumonia was 2.7 (CI: 1.3-5.4) times higher in children aged between 0.1 and 5.9 months; 1.9 (CI: 1.1-3.3) times higher in children who were hospitalized for 8-14 days; and three (CI: 1.2-7.5) times higher in children with a secondary diagnosis of malnutrition. The excess of avoidable hospitalizations is a clear indication of the low quality of care and limited accessibility to primary health care in indigenous territories, which is contrary to the assistance model proposed by the indigenous healthcare subsystem in Brazil, which should in theory focus on welfare technologies based on primary health care.
authors.affiliation: Centro de Ciências da Saúde, Universidade Federal de Roraima, Boa Vista, RR, Brasil, raquelvoges14@gmail.com.
authors.forename: Raquel Voges
authors.initials: RV
authors.lastname: Caldart
authors.affiliation: Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, AM, Brasil.
authors.forename: Lihsieh
authors.initials: L
authors.lastname: Marrero
authors.affiliation: Escola Nacional de Saúde Pública Sergio Arouca, Fiocruz, Rio de Janeiro, RJ, Brasil.
authors.forename: Paulo Cesar
authors.initials: PC
authors.lastname: Basta
authors.affiliation: Instituto Leônidas e Maria Deane, Fiocruz, Manaus, AM, Brasil.
authors.forename: Jesem Douglas Yamall
authors.initials: JD
authors.lastname: Orellana
mesh_terms: D000367:Age Factors; D000553:Ambulatory Care / Q000592:standards / Q000706:statistics & numerical data*; D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D005260:Female; D006297:Health Services Accessibility; D006303:Health Services, Indigenous / Q000592:standards / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007199:Indians, South American / Q000706:statistics & numerical data; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D011014:Pneumonia / Q000453:epidemiology*; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data*