Barriers and facilitators to the uptake of tuberculosis diagnostic and treatment services by hard-to-reach populations in countries of low and medium tuberculosis incidence: a systematic review of qualitative literature

Abstract

Tuberculosis (TB) disproportionally affects hard-to-reach populations,, such as the homeless, migrants, refugees, prisoners, substance misuers, people living with HIV. These people face important challenges in accessing and receiving quality health care services. To identify barriers to, and facilitators for, the uptake of TB diagnosis and treatment services by people from those hard-to-reach populations we performed a systematic reviewed of the qualitative literature following PRISMA guidelines, . Twelve studies were included in this review; most focussed on migrants. Views on perceived susceptibility to and severity of TB varied widely and included misconceptions. Stigma and challenges with accessing health care were identified as barriers for TB diagnosis and treatment uptake whereas nurse, family, and friends' support were facilitators to treatment compliance. Addressing barriers and facilitators may improve identification of potential TB cases and treatment in hard-to-reach populations. PROSPERO registration number: CRD420150194503

Homelessness and HIV: A Combination Predictive of Poor Tuberculosis Treatment Outcomes and in Need of Innovative Strategies to Improve Treatment Completion

“…In a 2017 systematic review, de Vries et al 11 outlined recommendations to improve TB program adherence in hardto-reach populations, including homeless populations. Their recommendations are germane to our study population and are as follows: 1).…”

Epidemiology of respiratory pathogen carriage in the homeless population within two shelters in Marseille, France, 2015–2017: cross sectional 1-day surveys

“…Respiratory diseases are frequently associated with death among homeless individuals [3]. Pulmonary tuberculosis is frequent in the homeless population and has been extensively studied [4,5].…”

Impact of nursing interventions on adherence to treatment with antituberculosis drugs in children and young people: A nonrandomized controlled trial

“…Both were nurse‐led actions that addressed the independent risk factors for nonadherence that had been identified in the retrospective phase of our study (being born abroad, the existence of a language barrier and the development of toxicity) (Guix‐Comellas et al., ). Immigration‐associated cultural and social problems have been previously identified as major risk factors for nonadherence (Abubakar et al., ; Anderson et al., ; Basterrechea, Sancho, Idígoras, & Temprano, ; de Vries et al., ; Heuvelings et al., ; Klinkenberg, Manissero, Semenza, & Verver, ; Mulder, Klinkenberg, & Manissero, ; Pang et al., ; Saunders & Evans, ; Zenner et al., ). Surprisingly, specific interventions aimed to overcome these barriers have scarcely been reported in the scientific literature (Ailinger et al., ).…”