Buchillet, Dominique <br/><br/>
Tuberculosis and Public Health: The Multiple Factors Involved in the Adherence to the Treatment Regimen 

 -  2001.<br/>							 
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<br/><br/> Tuberculosis, an infectious disease caused by the Koch bacilli ( Mycobacterium tuberculosis), constitutes a major public health problem throughout the world. Health professionals generally attribute the persistency of tuberculosis in a specific society or region to the weak adherence to treatment regimen by patients. They are perceived as responsible, individually, for the therapeutic failure and for the possible emergence of a multidrug-resistant tuberculosis. On a more general level, they are also blamed for the fiasco of national programs to control the disease. This article, a review of the medical and anthropological literature on tuberculosis, is also based on a médical anthropological research in the Brazilian Amazonia. It shows how various factors may influence the results of preventive and therapeutic efforts (public health policies, social and cultural characteristics of target populations, attitudes and expectations of both health personnel and patients). The clinical and epidemiological characteristics of tuberculosis, as well as the constraints on prevention and therapy as recommended by western medicine, require that strategies (in matters of diagnosis, prevention and treatment) should be drawn on the basis of a perfect knowledge of local contexts.