Dialogando sobre diagnóstico, tratamento e prevenção da febre reumática nas cinco regiões do Brasil, a partir de relatos de profi ssionais médicos: um retrato, em particular, da população adolescente, indígena e ribeirinha
Dialoguing about diagnosis, treatment and prevention of rheumatic fever in fi ve regions of Brazil from reports of medical professionals: a portrait, especially indigenous and riverbank-dwelling adolescents
Keywords:
Adolescent health, rheumatic fever, rheumatic heart disease, health of indigenous peoplesAbstract
Objective: To explore the treatment of rheumatic fever through testimonials on medical practice in different Brazilian
regions, using these experiences to identify possibilities for coping with reported adversities. Methods: This qualitative
study focuses on triangulation methods, with the survey analysis blended with a critical approach of the contexts studied,
as well as quantitative data on rheumatic heart disease in Brazil and a review of the literature. Interviews were conducted
with pediatricians, pediatric cardiologists and rheumatologists in referral hospitals that also offered healthcare training for
human resources in the cities of Curitiba, São Paulo, Rio de Janeiro, Belo Horizonte, Brasília, Salvador, Recife, Manaus and Rio
Branco. Interviews were conducted from November 2009 to July 2011. Results: Despite steadily progressing technological
developments in healthcare, some diseases are still typically tied to social inequalities. The survey indicates that diffi culties
in accessing healthcare persist all over Brazil, together with social and economic instability that is refl ected by insuffi cient
income and poor housing, among other factors. Conclusion: These conditions underpin the continuation of rheumatic
fever as a serious health problem in Brazil, especially in the North and Northeast. Furthermore, specifi c generational aspects
of adolescence on the one hand and regional and cultural diversity on the other, particularly in indigenous and riverbank
communities, can exacerbate the diffi culties imposed by this disease on these specifi c groups, thus requiring appropriate
policies for these segments of the population.
