Determinants of Acceptance of Tuberculosis Preventive Therapy among Household Contacts of Tuberculosis Patients: A Systematic Review
DOI:
https://doi.org/10.26911/jepublichealth.2026.11.03.08Abstract
Background: Tuberculosis Preventive Therapy (TPT) constitutes a central pillar in global TB elimination efforts; however, its implementation remains substantially below international targets. Data from the World Health Organization Regional Office for South-East Asia indicate that between 2018 and 2020, only 1.2 million household contacts aged <5 years (29% of the target) and 320,000 contacts aged ≥5 years (1.6% of the target) initiated TPT. This study aimed to identify the determinants influencing acceptance of TPT among household contacts of tuberculosis patients.
Subjects and Method: This systematic review followed PRISMA 2020 guidelines and the PICOS framework. It included analytical observational studies on household contacts of tuberculosis patients reporting determinants of TPT acceptance (acceptance, uptake, or initiation) with measures of association. Literature searches were conducted in PubMed, Scopus, Embase, or Web of Science, and Google Scholar for studies published between 2015 and 2026. Study selection involved screening of titles, abstracts, and full texts. Risk of bias was assessed using a modified Critical Appraisal Checklist for quantitative observational studies.
Results: A total of 14 studies were included, comprising 45,076 household contacts of tuberculosis patients. TPT acceptance ranged from 17% to 95% across studies. The most influential determinants of higher acceptance included active contact investigation and counseling, prior TB screening, shorter treatment regimens, and strong health system support. Key barriers were low perceived benefit, concerns about adverse effects, stigma, and limited access to healthcare services.
Conclusion: TPT acceptance among household contacts is primarily influenced by active contact investigation and counseling, prior TB screening, use of shorter treatment regimens, and strong health system support. In contrast, low perceived benefit, concerns about adverse effects, stigma, and limited healthcare access remain key barriers. Addressing these determinants through targeted, patient-centered interventions is essential to improve TPT uptake.
Keywords:
acceptance, preventive therapy, risk factors, treatment uptake, tuberculosisHow to Cite
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