Human and Social Capabilities Research Division, Human Sciences Research Council, Durban, South Africa
McGill Global Health Programme & McGill International TB Centre, McGill University, Montréal, Ontario, Canada.
BMJ Glob Health. 2020 May;5(5). doi: 10.1136/bmjgh-2019-002255.
Tuberculosis (TB) is treatable but is the leading infectious cause of death worldwide, with men over-represented in some key aspects of the disease burden. Men's TB epidemiological scenario occurs within a wider public health and historical context, including their prior sidelining in health discussions. Differences are however noticeable in how some Western countries and high TB and HIV burden low and middle-income countries (LMIC) including in Africa have approached the subject(s) of men and health. The former have a comparatively long history of scholarship, and lately are implementing actions targeting men's health and wellness, both increasingly addressing multilevel social and structural determinants. In contrast, in the latter men have received attention primarily for their sexual practices and role in HIV and AIDS and gender-based violence; moreover, interventions, guided by the public health approach, have stressed short-term, measurable and medical goals. Debates and the limited available empirical literature on men's engagement with TB-related healthcare are nevertheless indicating need for a shift, within TB work with men in high burden LMICs towards, structural and multicomponent interventions.
结核病（TB）是可治愈的，但它是全球导致死亡的主要传染病原因，在某些疾病负担的关键方面，男性的占比更高。男性的结核病流行病学情况发生在更广泛的公共卫生和历史背景下，包括他们在健康讨论中被边缘化。然而，在一些西方国家和结核病和艾滋病毒负担较高的低收入和中等收入国家（LMIC），包括非洲，如何处理男性和健康问题方面存在明显差异。前者有相对较长的学术研究历史，最近正在采取针对男性健康和健康的行动，这些行动越来越多地解决多层次的社会和结构性决定因素。相比之下，在后者中，男性主要因其性行为以及在艾滋病毒和艾滋病以及性别暴力中的作用而受到关注；此外，以公共卫生方法为指导的干预措施强调了短期、可衡量和医学目标。然而，关于男性参与与结核病相关的医疗保健的争论和有限的可用实证文献表明，在高负担的 LMIC 国家中，结核病工作需要转向针对男性的结构性和多方面干预措施。
