Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review.

Area of Science:

• Public Health
• Health Policy
• Epidemiology

Background:

• Active case-finding (ACF) is crucial for tuberculosis (TB) control.
• Understanding the factors influencing ACF policy development and implementation is essential for effective public health strategies.

Purpose of the Study:

• To explore the antecedents, components, and influencing factors of active case-finding (ACF) policy development and implementation.
• Identify knowledge gaps in ACF policy development and implementation research.

Main Methods:

• A scoping review of literature from January 1968 to January 2018.
• Searched MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, and WHO Library.
• Included studies in English, excluding those focused solely on latent TB, passive case-finding, childhood TB, or effectiveness without policy/implementation links. Conducted frequency and thematic analyses.

Main Results:

• Seventy-three articles met eligibility criteria, with most published after 2010.
• Studies were global, with a focus on Africa, Europe, and the Western Pacific regions.
• Key influencing factors for ACF implementation relate to health systems and community/individual determinants. Few studies addressed ACF policy development, with WHO recommendations noted as an antecedent. Health system capacity, integration, education, and collaboration are vital for ACF implementation.

Conclusions:

• Significant knowledge exists on ACF implementation facilitators and barriers, but less on how to leverage them.
• A substantial knowledge gap exists regarding contextual factors influencing ACF policy development.
• Further research is needed to inform and improve ACF policy development and implementation strategies.