Missing men with tuberculosis: the need to address structural influences and implement targeted and multidimensional...

Area of Science:

• Public Health
• Infectious Diseases
• Men's Health

Background:

• Tuberculosis (TB) remains the leading global infectious cause of death, with men experiencing a disproportionate burden.
• Historically, men's health issues, including TB, have been overlooked in public health discourse.
• Approaches to men's health vary significantly between Western countries and high TB/HIV burden low- and middle-income countries (LMICs).

Purpose of the Study:

• To analyze the epidemiological context of men and tuberculosis (TB).
• To compare approaches to men's health in Western countries versus high TB burden LMICs.
• To advocate for a shift in TB interventions targeting men in LMICs.

Main Methods:

• Review of existing literature and public health approaches concerning men and TB.
• Comparative analysis of health strategies in different global regions.
• Identification of gaps in current TB interventions for men.

Main Results:

• Western countries have a longer history of men's health scholarship and are implementing multilevel interventions.
• In high TB burden LMICs, men's health focus has primarily been on HIV/AIDS, sexual practices, and gender-based violence, with medical goals.
• Limited empirical literature highlights a need for more comprehensive, structural interventions for men with TB in LMICs.

Conclusions:

• Current TB interventions in high burden LMICs often overlook the specific needs and social determinants affecting men.
• A paradigm shift is necessary, moving from medicalized, short-term goals to structural, multicomponent interventions.
• Addressing men's engagement with TB healthcare requires a broader public health and social determinants approach.