Kulabako Christine Tricia, Neema Stella, Ninsiima Lesley Rose, Klein Jörn, Nabawanuka Lydia Namakula, Muleme James, Romano Javier Sánchez, Atekyereza Peter
Department of Sociology and Anthropology, Makerere University, Kampala, Uganda.
Department of Biosecurity, Ecosystems and Veterinary Public Health, Makerere University, Kampala, Uganda.
PLoS One. 2025 Apr 24;20(4):e0320364. doi: 10.1371/journal.pone.0320364. eCollection 2025.
Brucellosis is a zoonotic disease with significant public health and economic effects on societies. In Uganda, brucellosis is endemic and a primary contributor in livestock productivity losses. This is more worrisome for populations in the cattle corridor with high reliance on cattle and milk for nutritional value and symbol in social relations and identity. The community's social construction may affect comprehension of brucellosis hence leading to exposure and increased vulnerability to transmission. Despite brucellosis' high prevalence in the cattle corridor, little attention has been paid to its social construction. Hence, this study explored the interplay between gender dynamics, vulnerability and social construction of brucellosis transmission, in consideration of the unique socio-cultural context that characterizes cattle corridor populations.
Using an exploratory qualitative approach, the study was conducted in Nakasongola cattle corridor within three sub counties; Nabiswera, Nakitoma and Wabinyonyi using key informant interviews (KIIs) and focus group discussions (FGDs). Purposive sampling was used to identify participants for the four FGD [8-12] each from a subcounty though one was combined and 15 KIIs. Data were collected using face -to -face interviews with an interview guide that was structured using the Socio Ecological Model of Human Behaviour framework (SEMHB) constructs. Thematic analysis was conducted in NVivo 12 Pro incorporating both deductive (guided by the SEMHB) and inductive approaches (guided by the data).
The study identified important themes under each SEMHB influence level (Individual, Interpersonal, Community and Societal level). The study indicates that social composition and role distribution are driven by social and cultural expectations and significantly contribute to exposure and vulnerability to infection in the cattle corridor. For instance, it is paramount that women undergoing marriage preparations to be fed on raw milk for a certain period prior to their ceremony to enhance beauty. Also, important to note that use of personal protection to assist births is viewed by the community as opposing cultural norms, creating a perception of detachment from the highly valued cattle. Another noteworthy finding is the level of knowledge on brucellosis in terms of symptoms, transmission route, prevention and treatment at the interpersonal level. Furthermore, findings show practices such as the consumption of raw milk and assisted births, as being rooted in the social cultural norms, hence critical for transmission of brucellosis. At the community and organizational levels, the findings indicate an inadequate level of knowledge sharing and reluctance towards preventive measures as structural factors for the transmission of brucellosis and are ingrained in family and power relations.
The findings highlight that the social construction of brucellosis transmission is rooted in gender roles, social- cultural and power structures highlighting the influence of living process and spaces, at the different societal levels. Such complex dynamics play a critical role in determining individuals' susceptibility to infection as well as transmission potential of the disease-causing agent in cattle keeping communities. The gendered induced vulnerabilities related to the socio-cultural norms and familial roles, also play an important role in the exposure and spill over at the individual, interpersonal and community levels. The insufficient knowledge-sharing and reluctance to adopt preventive measures emerge as structural contributors to the persistence of brucellosis and other emerging zoonoses. These factors, intertwined with family dynamics and power relations, call for targeted interventions that address both individual behaviors and broader socio-cultural and institutional barriers to effective disease management and prevention. Conversely, policies that align with the community's social construction, gender and context are more likely to be feasible, adopted and sustained by the affected population.
布鲁氏菌病是一种人畜共患疾病，对社会有着重大的公共卫生和经济影响。在乌干达，布鲁氏菌病呈地方性流行，是牲畜生产力损失的主要原因。对于高度依赖牛和牛奶获取营养价值以及作为社会关系和身份象征的牛走廊地区的居民来说，这更令人担忧。社区的社会建构可能会影响对布鲁氏菌病的理解，从而导致暴露和感染风险增加。尽管布鲁氏菌病在牛走廊地区的患病率很高，但对其社会建构的关注却很少。因此，本研究考虑到牛走廊地区人群独特的社会文化背景，探讨了性别动态、易感性与布鲁氏菌病传播的社会建构之间的相互作用。
本研究采用探索性定性研究方法，在纳卡松戈拉牛走廊的三个乡（纳比斯韦拉、纳基托马和瓦宾约尼）开展，运用关键 informant 访谈（KIIs）和焦点小组讨论（FGDs）。采用目的抽样法从每个乡确定参与四个焦点小组讨论（每个小组 8 - 12 人）的参与者，其中一个小组合并进行，共 15 次关键 informant 访谈。通过面对面访谈收集数据，访谈指南依据人类行为社会生态模型框架（SEMHB）构建。在 NVivo 12 Pro 中进行主题分析，采用演绎法（以 SEMHB 为指导）和归纳法（以数据为指导）。
本研究在每个 SEMHB 影响层面（个体、人际、社区和社会层面）确定了重要主题。研究表明，社会构成和角色分配受社会和文化期望驱动，在牛走廊地区对暴露和感染易感性有显著影响。例如，至关重要的是，准备结婚的女性在婚礼前一段时间要饮用生牛奶以提升美貌。同样值得注意的是，社区认为在协助分娩时使用个人防护用品违背文化规范，这让人感觉与备受珍视的牛脱离了关系。另一个值得注意的发现是人际层面关于布鲁氏菌病症状、传播途径、预防和治疗的知识水平。此外，研究结果表明，饮用生牛奶和协助分娩等行为植根于社会文化规范，因此对布鲁氏菌病传播至关重要。在社区和组织层面，研究结果表明知识共享不足以及对预防措施的抵触是布鲁氏菌病传播的结构因素，并且在家庭和权力关系中根深蒂固。
研究结果凸显，布鲁氏菌病传播的社会建构植根于性别角色、社会文化和权力结构，在不同社会层面凸显了生活过程和空间的影响。这种复杂的动态在决定个体感染易感性以及牛养殖社区中病原体的传播潜力方面起着关键作用。与社会文化规范和家庭角色相关的性别导致的易感性，在个体、人际和社区层面的暴露和传播中也起着重要作用。知识共享不足和不愿采取预防措施成为布鲁氏菌病和其他新发人畜共患病持续存在的结构性因素。这些因素与家庭动态和权力关系相互交织，需要有针对性的干预措施，既要解决个体行为问题，也要解决更广泛的社会文化和制度障碍，以实现有效的疾病管理和预防。相反，与社区社会建构、性别和背景相契合的政策更有可能被受影响人群接受、采用并持续执行。
