Psychosocial and Economic Determinants of Tuberculosis Preventive Treatment: Systematic Literature Review

Abstract

Tuberculosis remains a pressing global public health challenge. Tuberculosis preventive treatment is central to tuberculosis elimination strategies, yet coverage and completion rates remain below international targets. The low success of the tuberculosis preventive treatment care cascade is shaped by complex social, economic, and psychological barriers among close contacts of tuberculosis patients. This study systematically reviews the literature to identify and synthesize factors influencing acceptance, adherence, and completion of tuberculosis preventive treatment. A systematic search was conducted in PubMed, Scopus, and Google Scholar, yielding 11 eligible studies based on predefined inclusion and exclusion criteria. Findings indicate that psychological determinants, including knowledge levels and risk perception, strongly predict treatment acceptance. Economic barriers, such as low household income and transportation costs, hinder treatment completion, while incentives and shorter regimens improve outcomes. Social factors, particularly family support and community-based management, enhance adherence compared with standard clinic-based care. Persistent barriers include disease-related stigma and fear of medication side effects. The review highlights that successful implementation of tuberculosis preventive treatment requires a multidimensional, person-centered approach integrating health education, economic support, and community engagement to overcome psychosocial barriers and accelerate global tuberculosis elimination.