Therapeutic itineraries and explanations for tuberculosis: an indigenous perspective

Résumé 0

"OBJECTIVE:To analyze explanations for tuberculosis and therapeuticitineraries of Brazilian indigenous people.METHODS:Case study with a qualitative-descriptive approach. Weconducted semi-structured interviews with 11 Munduruku indigenous,including direct observation of treatment for tuberculosis in the municipalityof Jacareacanga, south-western region of the state of Para, Brazil. To identifyexplanations for tuberculosis and therapeutic itineraries, we performedthematic content analysis.RESULTS:Traditional medicine was the first therapeutic option chosen bythe indigenous. However, biomedicine was also employed, which indicates acirculation between different therapeutic contexts and health concepts amongthe Munduruku. The explanations provided ranged from recognition of thesigns and symptoms specific to tuberculosis to the attribution of the diseaseto a spirit that leaves the body and wanders in the woods, returning ill intothe body. Unlike the biomedical model, which links tuberculosis transmissionstrictly to interpersonal contact, in closed spaces without natural lighting andventilation (preferably domestic environments), the Munduruku associatethe disease to an indirect contact between people socially distant (enemiesor adversaries) in public and open places.CONCLUSIONS:The explanations made by the indigenous are unique anddeserve the attention of those who are responsible for developing healthpublic policies, as well as of the teams who work on the villages. To guaranteean efficient control of tuberculosis in these regions, it is necessary that thedeveloped actions integrate biomedicine knowledge and the traditionalmedicine of the indigenous people, in addition to respecting and welcominglocal culture manifestations."