Littératie et résistances sociales face à l'implémentation du protocole de recherche numérique des « cas contacts des malades tuberculeux » en Côte d'Ivoire

The emergence of Coronavirus Disease 2019 (COVID-19) has profoundly transformed contact tracing strategies for infectious diseases. The rapid transmissibility of COVID-19 exposed the structural limitations of conventional manual contact tracing, which relies heavily on time-intensive epidemiological investigations and retrospective interviews. Such approaches proved insufficient in the face of highly contagious pathogens requiring rapid identification and interruption of transmission chains. In response, contact tracing practices were progressively digitized through the deployment of smartphone-based applications and wearable or sensor-based systems capable of automatically recording proximity events. Despite their epidemiological promise, digital contact tracing technologies have encountered persistent social resistance and limited adoption across both high-income and low- and middle-income countries. Adoption rates remain suboptimal, undermining the public health effectiveness of these tools. Furthermore, most digital tracing platforms are conceptualized and developed in technologically advanced contexts before being implemented elsewhere, often without adequate consideration of local socio-cultural, infrastructural, and literacy-related realities. The social acceptability of e-health technologies is not merely a function of technical performance but is deeply embedded in social structures, cultural norms, trust dynamics, and, critically, the level of health and digital literacy among target populations. Literacy shapes risk perception, technological comprehension, and the capacity to meaningfully engage with digital health innovations. Yet, its role in shaping resistance to digital contact tracing in sub-Saharan African contexts remains underexplored. This study therefore investigates the extent to which literacy contributes to social resistance to the adoption of a digital contact tracing and monitoring technology for tuberculosis in Abobo (Côte d’Ivoire). By situating technological adoption within its socio-cultural environment, this research aims to provide empirically grounded insights to inform the development of context-sensitive digital health interventions in low-resource settings.