Survey for tuberculosis in an indigenous population of Amazonia: the Suruí of Rondônia, Brazil

A cross-sectional survey was carried out in 2003 to investigate the epidemiology of tuberculosis (TB) among the Suruí Indians, Brazilian Amazon. A total of 736 subjects (50.7% females) were examined (80% of the total population). TB suspects underwent standardised evaluation for the presence of signs and/or symptoms of active TB, including chest radiography, PPD skin test, sputum microscopy examination for acid-fast bacilli and mycobacterial culture. A Bacillus Calmette-Guerin vaccine scar was detected in 699 individuals (95.0%). Of all the individuals examined, 120 (16.3%) had undergone previous TB treatment (46.7% females). One hundred and nine individuals were assessed as TB suspects (52.3% females). The survey identified six new cases of TB in the Suruí (three men and three women). Five of the six cases came from only two of the ten villages. Mycobacterium tuberculosis colonies grew from 5 (4.6%) samples (only two of which were also smear-positive) and mycobacteria other than M. tuberculosis were isolated from 14 (12.8%) samples. Diagnosis of TB based exclusively on clinical grounds was established only in the case of a 4-year-old girl. Based on this survey, the prevalence of active TB in the sampled group (N = 736) was 815.2 per 100 000. This study highlights the urgent need to review and strengthen control strategies directed at indigenous peoples in the country, taking into consideration their social, cultural and environmental differences.