Sociocultural dimensions of tuberculosis: An overview of key concepts

Abstract

Les innovations du domaine biomédical ont peu de chances de fournir des mesures de lutte contre la tuberculose (TB) à la fois efficaces et éthiques sans recherché complémentaire en sciences sociales. Cependant, le grand intérêt vis-à-vis du travail interdisciplinaire est souvent entravé par des différences de langage et de concepts spécifiques à chaque approche disciplinaire. Les chercheurs en biologie et en sciences sociales doivent apprendre à communiquer entre eux. Cet article va exposer les concepts clés relatifs à la TB en anthropologie médicale et sciences sociales. Distiller ces concepts dans un cadre conceptuel introductif vise à rendre ce matériel accessible aux chercheurs dans les laboratoires, en clinique et sur le terrain, ainsi qu’à encourager davantage de chercheurs en sciences sociales à s’engager dans la recherche sur la TB au sein des groupes cibles cruciaux en termes de succès des interventions. Pour des raisons pédagogiques, les concepts pertinents sont groupés en trois catégories: 1) structures et contextes qui incluent des thèmes transversaux comme les syndémies, la biologie locale, la médicalisation, la violence structurelle et la surveillance; 2) les pratiques et processus incluant le genre, la stigmatisation, les tabous et la culpabilisation des victimes; et 3) l’expérience et l’inculturation qui incluent les récits de maladies, la rupture biographique et le nominalisme dynamique. En contribuant à s’y retrouver dans cette littérature, nous espérons favoriser davantage de conversations interdisciplinaires entre les chercheurs du domaine qualitatif et quantitatif. La TB, une maladie typiquement sociale, sera contrôlée plus efficacement grâce à une approche multicanaux.

Full text

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Citation:
Mason, P.H., Degeling, C., Denholm, J. (2015) Sociocultural dimensions of tuberculosis: an
overview of key concepts, International Journal of Tuberculosis and Lung Disease, 19(10), pp.
1135-1143, doi: http://dx.doi.org/10.5588/ijtld.15.0066.
Contents: Page 1: Abstract in French
Page 2: Abstract in Spanish
Page 3: Abstract in English
Page 4: References
Les innovations du domaine biomédical ont peu de chances de fournir des mesures de lutte contre la
tuberculose (TB) à la fois efficaces et éthiques sans recherché complémentaire en sciences sociales.
Cependant, le grand intérêt vis-à-vis du travail interdisciplinaire est souvent entravé par des
différences de langage et de concepts spécifiques à chaque approche disciplinaire. Les chercheurs
en biologie et en sciences sociales doivent apprendre à communiquer entre eux. Cet article va
exposer les concepts clés relatifs à la TB en anthropologie médicale et sciences sociales. Distiller
ces concepts dans un cadre conceptuel introductif vise à rendre ce matériel accessible aux
chercheurs dans les laboratoires, en clinique et sur le terrain, ainsi qu’à encourager davantage de
chercheurs en sciences sociales à s’engager dans la recherche sur la TB au sein des groupes cibles
cruciaux en termes de succès des interventions. Pour des raisons pédagogiques, les concepts
pertinents sont groupés en trois catégories: 1) structures et contextes qui incluent des thèmes
transversaux comme les syndémies, la biologie locale, la médicalisation, la violence structurelle et
la surveillance; 2) les pratiques et processus incluant le genre, la stigmatisation, les tabous et la
culpabilisation des victimes; et 3) l’expérience et l’inculturation qui incluent les récits de maladies,
la rupture biographique et le nominalisme dynamique. En contribuant à s’y retrouver dans cette
littérature, nous espérons favoriser davantage de conversations interdisciplinaires entre les
chercheurs du domaine qualitatif et quantitatif. La TB, une maladie typiquement sociale, sera
contrôlée plus efficacement grâce à une approche multicanaux.

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Es poco probable que las innovaciones biomédicas ofrezcan medidas eficaces y éticas para el
control de la tuberculosis (TB) si no se acompañan de una investigación complementaria en
ciencias sociales. Sin embargo, un interés acentuado en el trabajo interdisciplinario suele verse
obstaculizado por diferencias en el lenguaje y los conceptos especí́ficosde los enfoques de cada
disciplina. En consecuencia, los investigadores de la sciencias biológicas y sociales deben
aprendera comunicarse entre sí. En el presente artí́culo se destacan conceptos básicos en materia de
TB, desde la perspectiva de la antropología médica y la sociología de la salud. Condensar estos
conceptos en un marco introductorio tiene por objeto hacer que este material sea más accessible a
los investigadores en los entornos de laboratorio y clínico y en el terreno, además de incitar cada
vez más a los científicos de las ciencias sociales a participar en la investigación de la TB dirigida a
los grupos clave, con el fin de mejorar la eficacia de las intervenciones programáticas. Con fines
pedagógicos, los conceptos primordiales se agruparon en las siguientes tres categorías: 1)
estructuras y entornos, que abarcan temas generales como las sindemias, las características
biológicas locales, la medicalización, la violencia estructural y la vigilancia; 2) las prácticas y los
procedimientos, que comprenden el género, los estigmas, los tabúes y la culpabilización de las
víctimas; y 3) la experiencia y la asimilación cultural, que incluyen los discursos sobre las
enfermedades, la ruptura biográfica y el nominalismo dinámico. Al ayudar a abordar esta literatura,
se espera fomentar las conversaciones interdisciplinarias entre los profesionales de la investigación
cualitativa y cuantitativa. La TB es una enfermedad social por excelencia y su control ser m́ s
eficaz cuando se aplique una estrategia polifacética de investigación.

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Biomedical innovations are unlikely to provide effective and ethical tuberculosis (TB) control
measures without complementary social science research. However, a strong interest in
interdisciplinary work is often under- mined by differences in language and concepts specific to
each disciplinary approach. Accordingly, biological and social scientists need to learn how to
communicate with each other. This article will outline key concepts relating to TB from medical
anthropology and health sociology. Distilling these concepts in an introductory framework is
intended to make this material accessible to researchers in laboratory, clinical and fieldwork
settings, as well as to encourage more social scientists to engage with TB research among target
groups critical for successful programmatic interventions. For pedagogical purposes, the relevant
concepts are grouped into three categories: 1) structures and settings, which includes overarching
themes such as syndemics, local biologies, medicalisation, structural violence and surveillance; 2)
practices and processes, encompassing gender, stigma, taboo, and victim blaming; and 3)
experience and enculturation, which includes illness narratives, biographical disruption and
dynamic nominalism. By helping to navigate this literature, we hope to foster more cross-
disciplinary conversations between qualitative and quantitative researchers. TB, a quintessential
social disease, will be controlled more effectively using a multistranded research approach.
Figure: Conceptualising socio-cultural considerations of tuberculosis care and prevention through
three mutually impacting spheres operating at individual, interpersonal and structural levels.

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