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Barriers and facilitators to pediatric tuberculosis management in India: a systematic review

Matthew Willis1, Joelle Van de Wetering2, Heynes Brown3

  • 1School of Medicine, Dentistry & Biomedical Sciences, Queen's University Belfast, Belfast, BT7 1NN, UK. mwillis11@qub.ac.uk.

BMC Infectious Diseases
|April 11, 2025
PubMed

Insights

Barriers to pediatric tuberculosis management in India include parental knowledge gaps, community stigma, and health system challenges. Facilitators involve inter-sectoral collaboration and advanced diagnostics like Xpert MTB/RIF.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Pediatrics

Background:

  • Pediatric tuberculosis (TB) poses a significant global health challenge, with India bearing a substantial burden.
  • Current TB control strategies often overlook pediatric cases, leading to suboptimal management and outcomes for children.
  • Understanding barriers and facilitators is crucial for enhancing pediatric TB care in India.

Purpose of the Study:

  • To systematically review and identify barriers and facilitators impacting pediatric TB management in India.
  • To analyze existing literature on challenges and enablers in pediatric TB diagnosis, treatment, and prevention.

Main Methods:

  • A systematic literature review was conducted using Embase, PubMed, and Web of Science databases.
  • Searches covered studies published from January 1, 2012, to September 7, 2024, focusing on pediatric TB management barriers and facilitators.
  • Twenty-four articles were included after screening 1132 original articles.

Main Results:

  • Individual-level barriers include parental knowledge gaps, financial constraints, and preference for private healthcare.
  • Community-level barriers involve gender inequality, stigma, crowded living conditions, and traditional practices.
  • Health system barriers encompass inadequate provider training, diagnostic challenges, resource limitations, and private sector issues. Facilitators include inter-sectoral collaboration and Xpert MTB/RIF use.

Conclusions:

  • Pediatric TB management in India is complex, influenced by multifaceted barriers at individual, community, and health system levels.
  • Identifying these challenges and facilitators provides critical insights for improving pediatric TB diagnosis, treatment, and prevention strategies.
  • Enhanced understanding is vital for advancing pediatric TB care in India and globally.
Abstract

Keywords:
PediatricPediatric tuberculosisSystematic reviewTuberculosisTuberculosis management

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