SOCIOLOGICAL AND ANTHROPOLOGICAL FACTORS RELATED TO THE COMMUNITY MANAGEMENT OF TUBERCULOSIS IN THE WESTERN CAPE COMMUNITIES OF RAVENSMEAD AND UITSIG

Objective. To determine the sociocultural understanding of tuberculosi s among patients and their household members. Design. Qualitative desc riptive study. Setting. Two adjacent Western Cape suburbs with a popul ation of approximately 35 000, a tuberculosis incidence of > 1 000/100 000 and a surface area of 2.42 km(2). Subjects. Twenty-three adult pa tients on treatment for tuberculosis and their adult household members . Interventions. None. Methodology. Consecutive selected adult tubercu losis patients and their household members were interviewed with an op en-ended interview schedule. General household and community condition s and non-verbal responses were recorded. Results. There were relative ly affluent but also severely deprived households with severe overcrow ding. Substance abuse was common. Patients had limited understanding a nd knowledge about health, hygiene and the cause of tuberculosis. Ther e was a perception of both physical and social distance between patien ts and health care providers. All patients relied exclusively on the c onventional biomedical curative approach of the medical system to deal with tuberculosis.