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Revista de Saúde Pública

Print version ISSN 0034-8910On-line version ISSN 1518-8787

Abstract

NOGUEIRA, Laura Maria Vidal; TEIXEIRA, Elizabeth; BASTA, Paulo Cesar  and  MOTTA, Maria Catarina Salvador da. Therapeutic itineraries and explanations for tuberculosis: an indigenous perspective. Rev. Saúde Pública [online]. 2015, vol.49, 96.  Epub Jan 22, 2016. ISSN 0034-8910.  http://dx.doi.org/10.1590/S0034-8910.2015049005904.

OBJECTIVE

To analyze explanations for tuberculosis and therapeutic itineraries of Brazilian indigenous people.

METHODS

Case study with a qualitative-descriptive approach. We conducted semi-structured interviews with 11 Munduruku indigenous, including direct observation of treatment for tuberculosis in the municipality of Jacareacanga, south-western region of the state of Para, Brazil. To identify explanations for tuberculosis and therapeutic itineraries, we performed thematic content analysis.

RESULTS

Traditional medicine was the first therapeutic option chosen by the indigenous. However, biomedicine was also employed, which indicates a circulation between different therapeutic contexts and health concepts among the Munduruku. The explanations provided ranged from recognition of the signs and symptoms specific to tuberculosis to the attribution of the disease to a spirit that leaves the body and wanders in the woods, returning ill into the body. Unlike the biomedical model, which links tuberculosis transmission strictly to interpersonal contact, in closed spaces without natural lighting and ventilation (preferably domestic environments), the Munduruku associate the disease to an indirect contact between people socially distant (enemies or adversaries) in public and open places.

CONCLUSIONS

The explanations made by the indigenous are unique and deserve the attention of those who are responsible for developing health public policies, as well as of the teams who work on the villages. To guarantee an efficient control of tuberculosis in these regions, it is necessary that the developed actions integrate biomedicine knowledge and the traditional medicine of the indigenous people, in addition to respecting and welcoming local culture manifestations.

Keywords : Tuberculosis; Indigenous Population; Medicine, traditional; Health Services, indigenous; Health Knowledge, attitudes, practice; Qualitative Research.

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