TUBERCULOSIS

Tuberculosis: A Cultural and Geographic Perspective

Introduction

Culture, religion, and geography all play a strong role in perceptions of health and illness. Health-seeking behaviors and lifestyle choices may also impact health-related outcomes and quality of life. Therefore, it is important to understand how socio-cultural variables like religion and worldview affect views towards specific diseases. An anthropological perspective on infectious diseases like tuberculosis helps public health advocates and nurses alike improve their responses to patient needs, tailor their heath outreach programs and campaigns to specific individuals or communities, and ensure better health outcomes.

Cultural Beliefs and Influences

Tuberculosis itself is not socially constructed, but beliefs about how the disease is contracted and how it spreads are. For example, cultural beliefs about social hierarchies, power, and subordination perceive tuberculosis as a product of hegemonic Western infrastructure that leads to environmental toxins causing the disease (Edginton, Sekatane & Goldestein, 2002, p. 1075). Stigma against the disease and those who have it also have a cultural context, and impact patient attitudes towards care and health-seeking behaviors. Cultural beliefs will also influence attitudes towards healthcare workers, and perceptions of educational materials distributed by local healthcare institutions (Moschetta, 2003). Mistrust of the healthcare system or the government may lead to a mistrust in the content of health education literature, challenging health educators and advocates to change the way they present these materials and educate their patients.

Religious and Spiritual Beliefs and Values

Religious and spiritual beliefs have a strong impact on attitudes towards how tuberculosis is contracted and how it spreads. For example, in some rural regions of South Africa, patients believe that tuberculosis results from breaking cultural rules that demand abstinence from sex after the death of a family member and after a woman has a spontaneous abortion, (Edginton, Sekatane & Goldstein, 2002, p. 1075). Perceived disease etiology will vary depending on culture and geographic context. In Cameroon, for example, infection may be attributed to possession by a spirit or the placing of a curse by a sorcerer (Grietens, Toomer, Um Boock, 2012).

Influence in Addressing the Issue

Religious and spiritual beliefs have generally hindered progress in treating, preventing, and eliminating tuberculosis in the most affected regions. When patients and their communities uphold religious beliefs about tuberculosis, it affects how, when,...…interventions, outreach, and education materials need to be written in the appropriate languages and with the appropriate cultural conventions to appeal to target audiences.

Countries

Tuberculosis is most prevalent in developing nations, with India, China, and Indonesia bearing the heaviest burdens (World Health Organization, n.d.). The disease is also prevalent in Africa. In wealthy nations, outbreaks are mainly concentrated among immigrant populations from these at-risk countries. Country-specific health data should better inform public health and outreach strategies, which can be funded by the highest burden nations and more relevant to their populations (Pai, 2018).

Conclusion

Geography, political affiliations, religion, and culture all impact attitudes and outlooks on health and wellness, with tremendous implications for public health policy and localized outreach services. How nurses choose to identify contextual variables will also have a strong bearing on patient perceptions, quality of care, and health outcomes. Tuberculosis is a persistent but preventable infectious disease with strong connections to geography, socioeconomic class status, and lifestyle factors. Understanding tuberculosis from a broader perspective that takes into account culture and context can help nurses and policy analysts come up with more effective solutions for containing and eliminating…