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Constellations of Pulmonary Citizenship
Transcript of Constellations of Pulmonary Citizenship
From Consumption to Tuberculosis
The discovery of microorganisms that caused the white plague gave rise to the notion that these microorganisms must be eliminated wherever they might be and the body must be strengthened to fight against them.
Emergence of reforms to people's morality, sociability, sexuality and daily habits with a focus on hygienic participation in the world
Increasing medicalisation bolstered by fears of contagion.
Hygiene was not just an imperative,
it was a right.
From sanatoria to DOTS
From surveillance of Tuberculars in treatment centres to surveillance of individuals in daily lives.
Loss of community among people with Tuberculosis
is a complex disease that involves biological, genetic, physical, social, political and economic factors. The World Health Organisation estimates that 2 billion people have been exposed to Mycobacterium tuberculosis and carry a latent infection, while an estimated 10% of these people have an active Tuberculosis disease. While the active disease is curable, the treatment is lengthy and not without complications. Lack of adherence to treatment and co-infection with HIV/AIDS is thought to have contributed to multi-drug resistant and extremely drug resistant strains of the disease. In addition to 0.43 million HIV-associated Tuberculosis deaths in 2011, between 1.3 and 1.6 million deaths from Mycobacterium tuberculosis alone makes Tuberculosis second only to HIV/AIDS as the greatest killer worldwide due to a single infectious disease. Sadly, 95% of cases and deaths occur in the developing world. Of 22 high-burden countries for Tuberculosis, nine are in Sub-Saharan Africa, six are in Southeast Asia, and the remaining seven are in North Asia, South Asia and South America. From people with a latent Tuberculosis infection to people with active Tuberculosis disease and those with co-infection, this paper will examine the constellations of pulmonary citizenship forged by social stigma, medicalisation, and treatment surveillance.
Paul H. Mason, Woolcock Institute of Medical Research
Drug Susceptible TB
4 drugs >6 month therapy
shorter simpler therapy
: drug-drug interactions with HIV medications
: ability to co-administer TB regimens with ARVs
Drug Resistant TB
(MDR-TB & XDR-TB)
few effective drugs,
injectable, toxicity, >5yrs
: oral, shorter, more efficacious, safer and lower cost therapy
Latent TB infection
6-9 months of treatment
shorter, safer preventive therapy
makeshift use of
formulations with correct closing
3. Resources: Educational & Material
According to the medical model....
BUT, these categories of Tubercular experience are bifurcated by dynamic social processes...
Vietnam is 1 of 22 countries with a high-burden of Tuberculosis
Together with local partners, Woolcock researchers commenced a 5-year study in 2010 to test the effectiveness of active case finding in contacts of patients with smear positive pulmonary tuberculosis, to estimate the cost-effectiveness of this strategy, and to examine the factors that influence the effectiveness.
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