The socioeconomic impact of tuberculosis on children and adolescents: a scoping review and conceptual framework

Abstract

Background Tuberculosis (TB) has been repeatedly shown to have socioeconomic impacts in both individual-level and ecological studies; however, much less is known about this effect among children and adolescents and the extent to which being affected by TB during childhood and adolescence can have life-course implications. This paper describes the results of the development of a conceptual framework and scoping review to review the evidence on the short- and long-term socioeconomic impact of tuberculosis on children and adolescents. Objectives To increase knowledge of the socioeconomic impact of TB on children and adolescents. Methods We developed a conceptual framework of the socioeconomic impact of TB on children and adolescents, and used scoping review methods to search for evidence supporting or disproving it. We searched four academic databases from 1 January 1990 to 6 April 2021 and conducted targeted searches of grey literature. We extracted data using a standard form and analysed data thematically. Results Thirty-six studies (29 qualitative, five quantitative and two mixed methods studies) were included in the review. Overall, the evidence supported the conceptual framework, suggesting a severe socioeconomic impact of TB on children and adolescents through all the postulated pathways. Effects ranged from impoverishment, stigma, and family separation, to effects on nutrition and missed education opportunities. TB did not seem to exert a different socioeconomic impact when directly or indirectly affecting children/adolescents, suggesting that TB can affect this group even when they are not affected by the disease. No study provided sufficient follow-up to observe the long-term socioeconomic effect of TB in this age group. Conclusion The evidence gathered in this review reinforces our understanding of the impact of TB on children and adolescents and highlights the importance of considering effects during the entire life course. Both ad-hoc and sustainable social protection measures and strategies are essential to mitigate the socioeconomic consequences of TB among children and adolescents.

Caregivers’ experiences and practices for malnourished children undergoing tuberculosis treatment in Eswatini

“…Therefore, improving the socioeconomic status of households through economic empowerment would help to decrease the prevalence of malnutrition among children under the age of 5 years. Atkins et al ( 2022 ) attest that TB has been repeatedly shown to have socioeconomic impacts in both individual level and ecological studies; however, much less is known about this among children and adolescents and the extent to which being affected by TB during childhood and adolescence can have life-course implications. Therefore, despite the negative impact on children’s caregivers regarding paediatric nutrition during TB treatment, possible solutions to compensate for or reverse this are of importance.…”

Perspectives of healthcare and social support sector policymakers on potential solutions to mitigate financial impact among people with TB in Mozambique: a qualitative study

“…The holistic impact of TB on well-being, finances and quality of life requires the simultaneous provision of biomedical and socioeconomic approaches to control TB, which in turn requires intersectoral collaboration especially between healthcare and social sectors. [14][15][16] However, despite a high proportion of people with TB and their households being economically vulnerable and likely to benefit significantly from social support, they are rarely covered by social support policies.…”

“…Therefore, there is a growing consensus that progress towards the ‘End TB Strategy’ targets will require not only investment in strengthening biomedical responses through improving access and effectiveness of healthcare delivery12 but also actions on the socioeconomic determinants and consequences of TB, as well as measures to improve quality of life and well-being after TB-episode,3 4 10 13 especially in low- and middle-income countries. The holistic impact of TB on well-being, finances and quality of life requires the simultaneous provision of biomedical and socioeconomic approaches to control TB, which in turn requires intersectoral collaboration especially between healthcare and social sectors 14–16. However, despite a high proportion of people with TB and their households being economically vulnerable and likely to benefit significantly from social support, they are rarely covered by social support policies.…”

“…In Mozambique as in many other settings, TB disease is not a formal criterion for social support, despite its severe consequences for people and families affected by it 15. To begin developing potential for such support requires collaboration between different sectors.…”

“…In Mozambique as in many other settings, TB disease is not a formal criterion for social support, despite its severe consequences for people and families affected by it. 15 To begin developing potential for such support requires collaboration between different sectors. To date, however, there is little knowledge about how a collaboration or pathway between the healthcare and social support sector would, or could, work in practice in Mozambique.…”