TB-MR como experiência biocultural: entre vulnerabilidade social, pluralismo terapêutico e desafios institucionais no distrito municipal de Kamaxaquene na Cidade de Maputo

Abstract

2.239 In a society rich in cultural diversity, knowing the diagnosis of its population is not enough; it is necessary to understand how patients cope with the new health condition, through the social construction of the illness, the explanatory models mobilized by patients, and how different systems of knowledge coexist and articulate in the therapeutic process. In this, the present study sought to understand the therapeutic itineraries, explanatory models, and sociocultural practices mobilized by patients with MDR-TB in the city of Maputo.

The research adopted a qualitative approach, of a descriptive and interpretative nature, inspired by the ethnographic perspective of the anthropology of health, analyzing how biomedicine, traditional medicine, and religious practices are articulated throughout the process of living with the diagnosis. The fieldwork took place between August 2024 and October 2025 and included semi-structured interviews and participant observation. Sixteen (16) patients diagnosed with MDR-TB and six health professionals working in tuberculosis care in the Kamaxaquene municipal district participated in the study. Data analysis was performed using thematic content analysis, allowing the identification of interpretative patterns, therapeutic practices, and sociocultural factors associated with the experience of the disease.

The results demonstrate that MDR-TB is experienced beyond its biomedical dimension, being interpreted through multiple explanatory models that include biological, spiritual, and social causes. The therapeutic itineraries reveal strong medical pluralism, characterized by circulation between health units, churches, and traditional medicine. It was also found that factors such as poverty, food insecurity, side effects of treatment, and social stigma significantly influence therapeutic adherence.

It is concluded that MDR-TB constitutes a biocultural phenomenon deeply marked by social inequalities and local cultural dynamics. Addressing it requires integrated approaches that combine biomedical treatment, psychosocial support, food security, and culturally sensitive communication strategies.(TRADUÇAO NOSSA)