Challenges in implementing preventive treatment for latent tuberculosis infection: a narrative review from provider and demand-side perspectives.

BACKGROUND

Preventive treatment is an important measure to interrupt the development of tuberculosis (TB) in people with latent tuberculosis infection (LTBI), which is among the key elements of TB prevention and control in the future. However, the implementation of preventive treatments has been affected by various factors and has fallen far short of expectations. Therefore, this study aims to systematically identify barriers to initiating and implementing LTBI preventive treatment globally from both demand-side and supply-side perspectives, providing targeted evidence to advance the End TB Strategy.

METHODS

We systematically searched PubMed and Embase for articles related to preventive treatments. All included articles were peer-reviewed English-language articles published between January 1, 2010, and August 31, 2024. The barriers affecting the initiation and implementation of preventive treatment were extracted from eligible articles and summarized from the two perspectives of supply side and demand side.

RESULTS

Low levels of awareness, concerns about adverse effects, longer treatment periods, and uncertainty regarding the effectiveness of treatment may influence the acceptance of preventive treatment. Furthermore, inadequate knowledge and experience of healthcare workers, limited human and material resources, and low policy priorities may partially hinder the implementation of preventive treatments.

CONCLUSION

Multidimensional interventions need to be developed to improve acceptance and adherence to preventive treatment and accelerate the implementation. This not only provides direction for future research but also provides a reference basis for clinical practice and policy development to accelerate the process of eliminating TB.