Health and disease among Panará (Kreen-Akarôre) Indians in Central Brazil after twenty-five years of contact with our world, with an emphasis on tuberculosis

The Panará, who had previously lived in isolation from Brazilian national society in the Amazon forest, were first contacted in 1973. Two years later they were moved to another area in Central Brazil. During this same period they were reduced to 82 members, the survivors of a population of 400 to 500 in the mid-1960s. In 1995 they returned to a small area in their old territory still not occupied by outsiders. There, three years later, a health survey showed a presumed diagnosis of tuberculosis in 15 individuals out of a population of 181. Further tests in the town of Colider, based on clinical data and chest X-rays, confirmed the diagnosis in 10 Panará (6 children under 10 years of age and 4 adults from 40 to 50 years old). BCG scars were present in the entire population. The nutritional status of Panará children was better than that of other indigenous groups in the Amazon region. The following measures were introduced for Tb control: a) treatment follow-up in the village, under direct supervision by both a nurse and the local indigenous health worker; b) compliance with defined criteria for ending treatment; c) periodic control of contacts and non-contacts; c) and establishment of a reference system with the health services in Colider.