Integrating narrative and bibliometric approaches to examine factors and impacts of tuberculosis treatment non-compliance
Keywords:
Tuberculosis, Treatment non-compliance, Multidrug-resistant tuberculosis, AdherenceAbstract
Background: Tuberculosis (TB) treatment non-compliance remains a significant global public health issue, undermining disease control efforts and leading to adverse clinical and epidemiological outcomes. While considerable research has explored this issue, gaps remain in understanding the multifactorial influences on non-compliance, particularly its key factors and impacts, as well as the interconnections that exacerbate these challenges. This study integrates narrative and bibliometric approaches to critically synthesize and visualize factors contributing to TB treatment non-compliance and its impacts. By addressing research gaps, this study aims to provide a comprehensive framework for understanding the multifactorial challenges and proposing evidence-informed strategies to address clinical and epidemiological issues.
Methods: A systematic search of Scopus, EBSCO (Medline), ScienceDirect, and PubMed databases identified empirical studies published up to December 2024. Thematic synthesis categorized factors into overarching themes, while bibliometric analysis using VOSviewer software visualized factors and their interconnections.
Results: The review identified key factors such as poor tuberculosis knowledge, stigma, side effects, and economic constraints, interacting with demographic, psychological, and systemic barriers. Network visualization highlighted the interconnections among these factors, illustrating how they compound to exacerbate non-compliance. Clinical and epidemiological impacts include MDR/XDR-TB, prolonged treatment, and community transmission.
Conclusions: TB treatment non-compliance arises from a complex interplay of individual, socio-economic, and healthcare-related factors. This review emphasizes the importance of integrated narrative and bibliometric approaches to develop context-specific strategies for improving adherence, reducing the global TB burden, and guiding future research and policy.
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