Challenges and Opportunities in Implementing Tuberculosis Prevention Therapy in Developing Countries: A Scoping Review
##semicolon##
https://doi.org/10.59188/eduvest.v5i11.52435##semicolon##
Tuberculosis##common.commaListSeparator## Therapy Prevention Tuberculosis##common.commaListSeparator## Developing CountriesAbstrakt
Tuberculosis Prevention Therapy (TPT) is an effort to prevent tuberculosis (TB) in people who have close contact with TB-positive patients. However, the challenges and opportunities in implementing TPT have not been fully explored. This study aims to examine the challenges and opportunities in implementing TPT within health services in developing countries. A systematic search was conducted using electronic databases (Scopus, PubMed, Science Direct, ProQuest) for literature published between 2015 and 2025. Following the PRISMA-ScR guidelines, 10 articles from various developing countries were included in the final analysis. Studies available in English with quantitative or qualitative designs and free full-text access were selected. The findings reveal that limited access to health services, inadequate health resources, insufficient knowledge, and adverse social environments constitute the primary challenges to implementation. Conversely, stakeholder support and strategic development of health services present significant opportunities to improve TPT uptake and completion. These insights provide evidence-based guidance for policymakers and healthcare practitioners to formulate targeted strategies that address implementation barriers and leverage existing opportunities to reduce the TB burden in resource-limited settings.
##submission.citations##
Alvi, Y., Philip, S., Anand, T., Chinnakali, P., Islam, F., Singla, N., et al. (2024). Situation analysis of early implementation of programmatic management of tuberculosis preventive treatment among household contacts of pulmonary TB patients in Delhi, India. Tropical Medicine and Infectious Disease, 9(1), 24. https://www.proquest.com/scholarly-journals/situation-analysis-early-implementation/docview/2918791813/se-2?accountid=49069
Amisi, J. A., Carter, E. J., Masini, E., & Szkwarko, D. (2021). Closing the loop in child TB contact management: Completion of TB preventive therapy outcomes in western Kenya. BMJ Open, 11(2). https://www.proquest.com/scholarly-journals/closing-loop-child-tb-contact-management/docview/2492520412/se-2?accountid=49069
Amuge, P. M., Ndekezi, D., Mugerwa, M., Bbuye, D., Ruthbarika, D. A., Kizza, L., et al. (2024). Facilitators and barriers to initiating and completing tuberculosis preventive treatment among children and adolescents living with HIV in Uganda: A qualitative study of adolescents, caretakers and health workers. AIDS Research and Therapy, 21, 1–12. https://www.proquest.com/scholarly-journals/facilitators-barriers-initiating-completing/docview/3102466554/se-2?accountid=49069
An, Y., Teo, A. K. J., Huot, C. Y., Tieng, S., Khun, K. E., Sok, H. P., et al. (2023). They don't have symptoms – why do they need to take medicines? Challenges in tuberculosis preventive treatment among children in Cambodia: A qualitative study. BMC Pulmonary Medicine, 23, 1–8. https://www.proquest.com/scholarly-journals/they-do-not-have-symptoms-why-need-take-medicines/docview/2788466106/se-2?accountid=49069
Appiah, M. A., Arthur, J. A., Gborgblorvor, D., Asampong, E., Kye-Duodu, G., Kamau, E. M., et al. (2023). Barriers to tuberculosis treatment adherence in high-burden tuberculosis settings in the Ashanti region, Ghana: A qualitative study from patients' perspective. BMC Public Health, 23(1), 1–12.
Barss, L., Obeng, J., Fregonese, F., Oxlade, O., Adomako, B., Afriyie, A. O., et al. (2020). Solutions to improve the latent tuberculosis cascade of care in Ghana: A longitudinal impact assessment. BMC Infectious Diseases, 20(1), 1–10.
Campbell, J. I., & Menzies, D. (2022). Testing and scaling interventions to improve the tuberculosis infection care cascade. Journal of the Pediatric Infectious Diseases Society, 11(Suppl 3), S94–S100.
Campbell, J. I., & Menzies, D. (2023). Testing and scaling interventions to improve TB infection care cascade. Journal of the Pediatric Infectious Diseases Society, 11(Suppl 3).
Datiko, D. G., Yassin, M. A., Theobald, S. J., & Cuevas, L. E. (2017). A community-based isoniazid preventive therapy for the prevention of childhood tuberculosis in Ethiopia. International Journal of Tuberculosis and Lung Disease, 21(9), 1002–1007.
Eshetu, A., Zewdu, D., Asfawesen, G., Yohannes, A., Tilay, T., Taye, J., et al. (2025). Community-based tuberculosis preventive treatment among child and adolescent household contacts in Ethiopia. Tropical Medicine and Infectious Disease, 10(4), 102. https://www.proquest.com/scholarly-journals/community-based-tuberculosis-preventive-treatment/docview/3194648253/se-2?accountid=49069
Fentahun, N., Wasihun, Y., Mamo, A., & Gebretsadik, L. A. (2020). Contact screening and isoniazid preventive therapy initiation for under-five children among pulmonary tuberculosis-positive patients in Bahir Dar Special Zone, Northwest Ethiopia: A cross-sectional study. Tuberculosis Research and Treatment, 2020, 1–8.
Ginderdeuren, E. van, Bassett, J., Hanrahan, C., Mutunga, L., & Van Rie, A. (2019). Health system barriers to implementation of TB preventive strategies in South African primary care facilities. PLOS ONE, 14(2). https://www.proquest.com/scholarly-journals/health-system-barriers-implementation-tb/docview/2180993633/se-2?accountid=49069
Heuvelings, C. C., de Vries, S. G., Greve, P. F., Visser, B. J., Bélard, S., Janssen, S., et al. (2017). Effectiveness of interventions for diagnosis and treatment of tuberculosis in hard-to-reach populations in countries of low and medium tuberculosis incidence: A systematic review. The Lancet Infectious Diseases, 27(5), e144–e158.
Hirsch-Moverman, Y., Mantell, J. E., Lebelo, L., Wynn, C., Hesseling, A. C., Howard, A. A., et al. (2018). Tuberculosis preventive treatment preferences among caregivers of children in Lesotho: A pilot study. International Journal of Tuberculosis and Lung Disease, 22(8), 858–862.
Hirsch-Moverman, Y., Mantell, J. E., Lebelo, L., Howard, A. A., Hesseling, A. C., Nachman, S., et al. (2020). Provider attitudes about childhood tuberculosis prevention in Lesotho: A qualitative study. BMC Health Services Research, 20(1), 1–8.
Makova, N. C., Muchekeza, M., Chirenda, J., Chadambuka, A., Govha, E., Juru, T. P., et al. (2022). An evaluation of the isoniazid preventive therapy program performance for under-fives in Kwekwe City, January 2019–December 2020: A descriptive cross-sectional study. Pan African Medical Journal, 42.
Masini, E., Mungai, B., & Wandwalo, E. (2020). Tuberculosis preventive therapy uptake barriers: What are the low-lying fruits to surmount this? Public Health Action, 10(1), 83–72.
Ministry of Health of the Republic of Indonesia. (2020). Technical guidelines for handling latent tuberculosis infection (ILTB) (I. Pambudi, S. Widada, & E. Lukitosari, Eds.). Ministry of Health of the Republic of Indonesia. https://tbindonesia.or.id/wp-content/uploads/2021/01/Isi-Juknis-ILTB-FINAL-ok_published.pdf
Samudyatha, U. C., Soundappan, K., Ramaswamy, G., Mehta, K., Kumar, C., Jagadeesh, M., et al. (2023). Outcomes and challenges in the programmatic implementation of tuberculosis preventive therapy among household contacts of pulmonary TB patients: A mixed-methods study from a rural district of Karnataka, India. Tropical Medicine and Infectious Disease, 8(12), 512.
Santesso, N., Mustafa, R. A., Schünemann, H. J., Arbyn, M., Blumenthal, P. D., Cain, J., et al. (2016). World Health Organization guidelines for treatment of cervical intraepithelial neoplasia 2–3 and screen-and-treat strategies to prevent cervical cancer. International Journal of Gynecology & Obstetrics, 132(3), 252–258.
Singh, A. R., Kharate, A., Bhat, P., Kokane, A. M., Bali, S., Sahu, S., et al. (2017). Isoniazid preventive therapy among children living with tuberculosis patients: Is it working? A mixed-method study from Bhopal, India. Journal of Tropical Pediatrics, 63(4), 274–285.
Souza, A. B., Arriaga, M. B., Amorim, G., Araújo-Pereira, M., Nogueira, B. M. F., Queiroz, A. T. L., et al. (2021). Determinants of losses in the latent tuberculosis infection cascade of care in Brazil. BMJ Global Health, 6(9), 1–8.
Surie, D., Interrante, J. D., Pathmanathan, I., Patel, M. R., Anyalechi, G., Cavanaugh, J. S., et al. (2019). Policies, practices and barriers to implementing tuberculosis preventive treatment—35 countries, 2017. International Journal of Tuberculosis and Lung Disease, 23(12), 1308–1313.
Szkwarko, D., Hirsch-Moverman, Y., Du Plessis, L., Du Preez, K., Carr, C., & Mandalakas, A. M. (2017). Child contact management in high tuberculosis burden countries: A mixed-methods systematic review. PLOS ONE, 12(8), 1–23.
Tefera, F., Barnabee, G., Sharma, A., Feleke, B., Atnafu, D., Haymanot, N., et al. (2019). Evaluation of facility and community-based active household tuberculosis contact investigation in Ethiopia: A cross-sectional study. BMC Health Services Research, 19(1), 1–9.
Vasiliu, A., Salazar-Austin, N., Trajman, A., Lestari, T., Mtetwa, G., Bonnet, M., et al. (2022). Child contact case management—a major policy–practice gap in high-burden countries. Pathogens, 11(1), 1–15.
Vasiliu, A., Tiendrebeogo, G., Awolu, M. M., Akatukwasa, C., Tchakounte, B. Y., Ssekyanzi, B., et al. (2022). Feasibility of a randomized clinical trial evaluating a community intervention for household tuberculosis child contact management in Cameroon and Uganda. Pilot and Feasibility Studies, 8, 1–12.
WHO. (2024). Global tuberculosis report 2024 (pp. 1–50). https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2024
Wysocki, A. D., Villa, T. C. S., Arakawa, T., Brunello, M. E. F., Vendramini, S. H. F., Monroe, A. A., et al. (2016). Latent tuberculosis infection diagnostic and treatment cascade among contacts in primary health care in a city of Sao Paulo state, Brazil: A cross-sectional study. PLOS ONE, 11(6), 1–12.
Yassin, M. A., Yirdaw, K. D., Datiko, D. G., Cuevas, L. E., & Yassin, M. A. (2020). Yield of household contact investigation of patients with pulmonary tuberculosis in southern Ethiopia. BMC Public Health, 20(1), 1–9.
Yuen, C. M., Millones, A. K., Galea, J. T., Puma, D., Jimenez, J., Lecca, L., et al. (2021). Toward patient-centered tuberculosis preventive treatment: Preferences for regimens and formulations in Lima, Peru. BMC Public Health, 21(1), 1–8.
Ryckman, T., Weiser, J., Gombe, M., Turner, K., Soni, P., Tarlton, D., et al. (2023). Impact and cost-effectiveness of short-course tuberculosis preventive treatment for household contacts and people with HIV in 29 high-incidence countries: A modeling analysis. The Lancet Global Health, 11(8), e1205–e1216. http://dx.doi.org/10.1016/S2214-109X(23)00251-6
##submission.downloads##
Publikované
##submission.howToCite##
Číslo
Sekcia
##submission.license##
##submission.copyrightStatement##
##submission.license.cc.by-sa4.footer##
