학술논문

‘TB is a disease which hides in the body’: Qualitative data on conceptualisations of tuberculosis recurrence among patients in Zambia and South Africa
Document Type
article
Source
Global Public Health, Vol 17, Iss 8, Pp 1713-1727 (2022)
Subject
tb
recurrent tb
post-tuberculosis
lung health
quality of life
Public aspects of medicine
RA1-1270
Language
English
ISSN
1744-1692
1744-1706
17441692
Abstract
The WHO estimates 58 million people experienced one or more TB disease episodes between 2000 and 2018. These ‘former TB patients’ are at greater risk of future TB infection and death than TB naïve people. Additionally, former TB patients experience social, psychological, and physiological difficulties after microbiological cure. Drawing on semi-structured interviews collected with 28 people from communities in Zambia (n = 8) and South Africa (n = 2) between October 2018 and March 2019, we describe their perceptions of having two or more TB episodes. Utilising a discursive analytic approach, we interrogated how participants conceptualise their risk of disease recurrence. Despite being surprised by subsequent TB episodes, participants utilised their bodily experiences of TB signs and symptoms alongside their experiential knowledge of health systems processes to procure timely diagnosis and care. Yet, many participants were unable to resume social and economic participation. Experiences of multiple TB episodes and correlating social, economic, and physiological vulnerabilities, challenged participants biomedical understanding of TBs curability. Through notions of dirt and ‘staining’, participants conceptualise TB as a sinister, malicious presence they are bound to encounter time and again. Health providers should discuss the risk of TB recurrence with patients and promote prevention, early detection, and diagnosis of TB disease.