"Two Cultures in Favor of a Dying Patient": Experiences of Health Care Professionals Providing Snakebite Care to Indigenous Peoples in the Brazilian Amazon.

Brazilian Amazon access to health care antivenom indigenous peoples intercultural health care snakebite envenomations

Journal

Toxins
ISSN: 2072-6651
Titre abrégé: Toxins (Basel)
Pays: Switzerland
ID NLM: 101530765

Informations de publication

Date de publication:
03 03 2023
Historique:
received: 02 02 2023
revised: 14 02 2023
accepted: 21 02 2023
medline: 30 3 2023
entrez: 28 3 2023
pubmed: 29 3 2023
Statut: epublish

Résumé

In the Brazilian Amazon, deaths and disabilities from snakebite envenomations (SBEs) are a major and neglected problem for the indigenous population. However, minimal research has been conducted on how indigenous peoples access and utilize the health system for snakebite treatment. A qualitative study was conducted to understand the experiences of health care professionals (HCPs) who provide biomedical care to indigenous peoples with SBEs in the Brazilian Amazon. Focus group discussions (FGDs) were carried out in the context of a three-day training session for HCPs who work for the Indigenous Health Care Subsystem. A total of 56 HCPs participated, 27 in Boa Vista and 29 in Manaus. Thematic analysis resulted in three key findings: Indigenous peoples are amenable to receiving antivenom but not to leaving their villages for hospitals; HCPs require antivenom and additional resources to improve patient care; and HCPs strongly recommend a joint, bicultural approach to SBE treatment. Decentralizing antivenom to local health units addresses the central barriers identified in this study (e.g., resistance to hospitals, transportation). The vast diversity of ethnicities in the Brazilian Amazon will be a challenge, and additional studies should be conducted regarding preparing HCPs to work in intercultural contexts.

Identifiants

pubmed: 36977085
pii: toxins15030194
doi: 10.3390/toxins15030194
pmc: PMC10051728
pii:
doi:

Substances chimiques

Antivenins 0

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

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Auteurs

Felipe Murta (F)

Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, Brazil.
Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil.
Instituto Leônidas and Maria Deane, Fundação Oswaldo Cruz, Manaus 69057-070, Brazil.

Eleanor Strand (E)

Department of Emergency Medicine, Duke University School of Medicine, Durham, NC 27708, USA.

Altair Seabra de Farias (AS)

Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, Brazil.
Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil.

Felipe Rocha (F)

Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, Brazil.
Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil.

Alícia Cacau Santos (AC)

Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, Brazil.
Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil.

Evellyn Antonieta Tomé Rondon (EAT)

Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, Brazil.
Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil.

Ana Paula Silva de Oliveira (APS)

Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil.

Hiran Satiro Souza da Gama (HSS)

Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, Brazil.
Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil.

Yasmim Vieira Rocha (Y)

Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, Brazil.
Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil.

Gisele Dos Santos Rocha (GDS)

Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, Brazil.
Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil.

Mena Ferreira (M)

Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, Brazil.
Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil.

Vinícius Azevedo Machado (V)

Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, Brazil.
Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil.

Marcus Lacerda (M)

Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, Brazil.
Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil.
Instituto Leônidas and Maria Deane, Fundação Oswaldo Cruz, Manaus 69057-070, Brazil.

Manuela Pucca (M)

Curso de Medicina, Universidade Federal de Roraima, Boa Vista 69310-000, Brazil.

Felipe Cerni (F)

Curso de Medicina, Universidade Federal de Roraima, Boa Vista 69310-000, Brazil.

João Ricardo Nickenig Vissoci (JR)

Department of Emergency Medicine, Duke University School of Medicine, Durham, NC 27708, USA.

Anna Tupetz (A)

Department of Emergency Medicine, Duke University School of Medicine, Durham, NC 27708, USA.

Charles J Gerardo (CJ)

Department of Emergency Medicine, Duke University School of Medicine, Durham, NC 27708, USA.

Ana Maria Moura-da-Silva (AM)

Instituto Butantan, São Paulo 05503-900, Brazil.

Fan Hui Wen (F)

Instituto Butantan, São Paulo 05503-900, Brazil.

Jacqueline Sachett (J)

Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, Brazil.
Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil.
Diretoria de Ensino e Pesquisa, Fundação Alfredo da Matta, Manaus 69065-130, Brazil.

Wuelton Monteiro (W)

Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, Brazil.
Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil.

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Classifications MeSH