Private sector engagement in tuberculosis detection: a bibliometric analysis

This study presents the first comprehensive bibliometric analysis of scientific publications in the field of the private sector's role in tuberculosis detection and diagnosis from 1964 to 2025. Using PRISMA, data were extracted from Scopus and Web of Science, yielding 616 original research articles published in 224 journals. Bibliometric performance analysis was done using Pivot Tables. Keyword co-occurrence analysis was performed using VOSviewer software to identify thematic structures. The results reveal a steady increase in publication activity since the early 2000s, reflecting growing recognition of the private sector as a critical actor in tuberculosis control. Analysis of the ten most cited articles revealed four recurring issues: suboptimal quality of care, diagnostic delays, high financial burdens on patients, and the critical need for structured public-private collaboration. The co-occurrence analysis identified five main thematic clusters. The largest cluster, "Delays and Catastrophic Costs," highlights persistent diagnostic delays, high costs, and fragmented care within the private sector. The clusters, "Diagnostic Challenges in Private Practice" and "Case Detection and Private Practitioners", further underscore deficiencies in diagnostic quality and coordination. Conversely, the clusters, "Public-Private Mix" and "Diagnostics and Private Providers", demonstrate the sector's potential to expand diagnostic coverage, enhance case notification, and reduce the burden on public facilities when effective collaboration and regulatory oversight exist. Despite encouraging progress being made, we identified gaps, particularly regarding regulatory mechanisms, cost-effectiveness evaluation, and data standardisation. Strengthening governance, integrating innovative diagnostics, and incentivising quality assurance are future research directions to fully harness the private sector's contribution to ending the tuberculosis epidemic.