Représentations de la Covid-19 et itinéraires thérapeutiques des personnes atteintes de tuberculose à Biyem-assi : contribution à l’anthropologie médicale

Abstract

The present dissertation is entitled: « Représentations de la Covid-19 et itinéraires thérapeutiques des personnes atteintes de tuberculose à Biyem-assi : contribution à l’Anthropologie médicale ». The choice of this topic was motivated by a deep desire to understand the influence of the Covid-19 pandemic on the therapeutic pathways of individuals with tuberculosis. Indeed, tuberculosis remains a major public health problem in Cameroon. The advent of Covid-19 has had a devastating effect on the fight against this infectious disease. Despite the measures taken in terms of healthcare to ensure the continuity of tuberculosis care during the Covid-19 pandemic, there has been a decrease in the notification of cases of drug-susceptible TB and drug-resistant TB, stigmatization of the TB centers treating Covid-19, reduced attendance at healthcare facilities, and non-adherence to recommended Covid-19 prevention measures by health authorities, as well as patients seeking alternative types of care deemed appropriate for their condition. Our research focuses on the main question of how representations of Covid-19 influence the therapeutic pathways of individuals with tuberculosis. This inquiry led to the main hypothesis that representations of Covid-19 influence the therapeutic pathways of individuals with tuberculosis by accentuating the diversification of healthcare options, directing them to different sectors of the healthcare system. The general objective of this research is therefore to describe how representations related to Covid-19 influence the therapeutic pathways of individuals with tuberculosis. In order to achieve this objective, we conducted a documentary research and fieldwork. The former relied on the review of various documents related to our research topic, while the latter emphasized the usual data collection techniques in Anthropology, namely direct observation and in-depth interviews. The collected data were analyzed using content analysis technique. These data were interpreted in light of the theory of social representations, interpretive approach, and ethnomethodology. The analysis of the collected data shows that in Biyem-assi, there are various representations of tuberculosis and Covid-19, which are socio-cultural, biomedical, religious, and social in nature, and they originate from different sources of information, including the patient's own experience, information obtained from healthcare professionals, information transmitted by the media, interactions with members of their social circle, and indigenous knowledge specific to each socio-cultural group. During the Covid-19 pandemic, individuals with tuberculosis resorted to various types of therapies, including self-medication, ethnomedicine, biomedicine, and religious therapies. Thus, the representations that patients and their social circle hold about Covid-19 have intensified the diversification of therapeutic pathways, leading them to different sectors of the healthcare system, highlighting therapeutic pluralism among individuals with tuberculosis during the Covid-19 pandemic.