{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:32:24Z","timestamp":1791639144092,"version":"4.3.4"},"reference-count":144,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2021,9,25]],"date-time":"2021-09-25T00:00:00Z","timestamp":1632528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>In line with the 1000-day initiative and the Sustainable Development Goals (SDG) 2 and 3, we present a cross-sectional analysis of maternal health, infant nutrition, and methylmercury exposure within hard-to-reach indigenous communities in the state of Par\u00e1, Brazilian Amazon. We collected data from all women of childbearing age (i.e., 12\u201349) and their infants under two years old in three Munduruku communities (Sawr\u00e9 Muybu, Sawr\u00e9 Aboy, and Poxo Muybu) along the Tapajos River. We explored health outcomes through interviews, vaccine coverage and clinical assessment, and determined baseline hair methylmercury (H-Hg) levels. Hemoglobin, infant growth (Anthropometric Z scores) and neurodevelopment tests results were collected. We found that 62% of women of childbearing age exceeded the reference limit of 6.0 \u03bcg\/g H-Hg (median = 7.115, IQR = 4.678), with the worst affected community (Sawr\u00e9 Aboy) registering an average H-Hg concentration of 12.67 \u03bcg\/g. Half of infants aged under 24 months presented with anemia. Three of 16 (18.8%) infants presented H-Hg levels above 6.0 \u00b5g\/g (median: 3.88; IQR = 3.05). Four of the 16 infants were found to be stunted and 38% of women overweight, evidencing possible nutritional transition. No infant presented with appropriate vaccination coverage for their age. These communities presented with an estimated Infant Mortality Rate (IMR) of 86.7\/1000 live births. The highest H-Hg level (19.6 \u00b5g\/g) was recorded in an 11-month-old girl who was found to have gross motor delay and anemia. This already vulnerable indigenous Munduruku community presents with undernutrition and a high prevalence of chronic methylmercury exposure in women of childbearing age. This dual public health crisis in the context of wider health inequalities has the potential to compromise the development, health and survival of the developing fetus and infant in the first two critical years of life. We encourage culturally sensitive intervention and further research to focus efforts.<\/jats:p>","DOI":"10.3390\/ijerph181910091","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T04:55:33Z","timestamp":1632718533000},"page":"10091","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["An Assessment of Health Outcomes and Methylmercury Exposure in Munduruku Indigenous Women of Childbearing Age and Their Children under 2 Years Old"],"prefix":"10.3390","volume":"18","author":[{"given":"Joeseph William","family":"Kempton","sequence":"first","affiliation":[{"name":"Faculty of Medicine, St Mary\u2019s Hospital, Imperial College London, London W2 1PG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5253-5774","authenticated-orcid":false,"given":"Andr\u00e9 Reynaldo Santos","family":"P\u00e9riss\u00e9","sequence":"additional","affiliation":[{"name":"Departamento de Endemias Samuel Pessoa, Escola Nacional de Sa\u00fade P\u00fablica, Funda\u00e7\u00e3o Oswaldo Cruz (ENSP\/Fiocruz), Rua Leopoldo Bulh\u00f5es, 1480, Manguinhos, Rio de Janeiro 21041-210, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8633-0913","authenticated-orcid":false,"given":"Cristina Barroso","family":"Hofer","sequence":"additional","affiliation":[{"name":"Instituto de Pediatria e Puericultura Martag\u00e3o Gesteira, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rua Bruno Lobo, 50, Cidade Universit\u00e1ria, Rio de Janeiro 21941-912, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Claudia Santiago","family":"de Vasconcellos","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Educa\u00e7\u00e3o Profissional em Vigil\u00e2ncia em Sa\u00fade, Escola Polit\u00e9cnica de Sa\u00fade Joaquim Ven\u00e2n-cio, Funda\u00e7\u00e3o Oswaldo Cruz (EPSJV\/Fiocruz), Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Victor","family":"de Sousa Viana","sequence":"additional","affiliation":[{"name":"Centro de Refer\u00eancia Professor H\u00e9lio Fraga, Escola Nacional de Sa\u00fade P\u00fablica, Funda\u00e7\u00e3o Oswaldo Cruz (CRPHF\/ENSP\/Fiocruz), Estrada de Curicica, 2000, Curicica, Rio de Janeiro 22780-195, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"de Oliveira Lima","sequence":"additional","affiliation":[{"name":"Se\u00e7\u00e3o de Meio Ambiente, Instituto Evandro Chagas, Secretaria de Vigil\u00e2ncia em Sa\u00fade, Minist\u00e9rio da Sa\u00fade (SEAMB\/IEC\/SVS\/MS), Rodovia BR-316 km 7 s\/n, Levil\u00e2ndia 67030-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iracina Maura","family":"de Jesus","sequence":"additional","affiliation":[{"name":"Se\u00e7\u00e3o de Meio Ambiente, Instituto Evandro Chagas, Secretaria de Vigil\u00e2ncia em Sa\u00fade, Minist\u00e9rio da Sa\u00fade (SEAMB\/IEC\/SVS\/MS), Rodovia BR-316 km 7 s\/n, Levil\u00e2ndia 67030-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8222-0992","authenticated-orcid":false,"given":"Sandra","family":"de Souza Hacon","sequence":"additional","affiliation":[{"name":"Departamento de Endemias Samuel Pessoa, Escola Nacional de Sa\u00fade P\u00fablica, Funda\u00e7\u00e3o Oswaldo Cruz (ENSP\/Fiocruz), Rua Leopoldo Bulh\u00f5es, 1480, Manguinhos, Rio de Janeiro 21041-210, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0804-0413","authenticated-orcid":false,"given":"Paulo Cesar","family":"Basta","sequence":"additional","affiliation":[{"name":"Departamento de Endemias Samuel Pessoa, Escola Nacional de Sa\u00fade P\u00fablica, Funda\u00e7\u00e3o Oswaldo Cruz (ENSP\/Fiocruz), Rua Leopoldo Bulh\u00f5es, 1480, Manguinhos, Rio de Janeiro 21041-210, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1136\/archdischild-2019-316929","article-title":"The First Thousand Days: Early, Integrated and Evidence-Based Approaches to Improving Child Health: Coming to a Population near You?","volume":"105","author":"Darling","year":"2020","journal-title":"Arch. 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