Tuberculosis prevention in low- and middle-income settings in the Asia-Pacific region, a qualitative scoping review

Tuberculosis (TB) is a leading cause of death globally, with most new TB cases notified in the Asia-Pacific region. We aimed to synthesize qualitative research of TB prevention strategies from the region, summarizing reported barriers to and facilitators of practices, and identifying important gaps and opportunities for future research. A scoping review was conducted using the Arksey and O'Malley framework and includes qualitative studies published in the Asia-Pacific region between 2015 and 2025. Six databases were searched to identify qualitative studies (or qualitative components of mixed-methods studies) that focused on TB prevention. Articles were assessed for inclusion by two authors who independently screened articles based on predetermined key words and criteria. Of 1745 articles identified, 40 were included in this review. Most qualitative research addressed secondary rather than primary prevention, such as treatment of TB infection and early detection and treatment of disease. Articles largely focused on healthcare workers, while vulnerable populations-such as pregnant women and people living with HIV-are underrepresented. Key barriers identified included health system weaknesses, TB-related stigma, and unclear infection control policies. Strengthening health systems, decentralizing TB services, and engaging communities were identified as crucial to ensuring accessible and sustainable TB prevention efforts.