Community-based interventions to improve tuberculosis treatment outcomes: A meta-analysis

Area of Science:

• Public Health
• Infectious Diseases
• Health Services Research

Background:

• Tuberculosis (TB) remains a major global health challenge despite medical advancements, with treatment completion, not drug availability, being the primary obstacle.
• Biomedical solutions alone are insufficient; patient recovery is heavily influenced by social determinants like adherence and support systems.
• Existing digital and community-led interventions show promise in addressing these gaps, but their combined effectiveness requires synthesis.

Purpose of the Study:

• To systematically synthesize the pooled effectiveness of digital and community-led interventions on tuberculosis treatment completion.
• To provide evidence-based insights for improving global TB control strategies.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (PubMed, Scopus, Web of Science, etc.) for studies published between 2021 and 2025.
• Two independent reviewers assessed study quality using JBI tools, and data were analyzed using a random-effects model in JASP (version 0.19).
• Pooled odds ratios and 95% confidence intervals were computed to determine the overall effect size.

Main Results:

• The analysis included 20 controlled trials with 76,757 participants, identified from over 17,000 records.
• Community-aligned and digital interventions demonstrated a significant improvement in the likelihood of TB treatment completion (pooled OR = 1.11; 95% CI: 1.02-1.20; p = 0.018).
• High heterogeneity was observed between studies (Q = 90.24, p < 0.001), but the positive effect of interventions was consistent across different settings.

Conclusions:

• Tuberculosis treatment success is contingent upon factors beyond medication, including patients' social stability, food security, and adherence capacity.
• Integrating socioeconomic support with medical regimens is crucial for effective TB control and achieving meaningful patient recovery.
• Digital and community-based strategies are vital components for enhancing TB treatment completion and patient outcomes.