結核管理に影響を与える社会文化要因に関するスコ—ピングレビュー：世界的な研究からのエビデンス

Tuberculosis (TB) remains a pressing global health challenge, ranking among the leading causes of death from a single infectious agent. In 2021, the World Health Organisation (WHO) estimated 10.6 million new TB cases and 1.6 million TB-associated deaths globally, underscoring the enduring burden of the disease. The review aimed to explore and map the socio-cultural factors affecting TB control by synthesising evidence from diverse global studies.

This review adhered to the six steps outlined in the guidelines by Askey and O'Malley. Search was conducted across four main databases, including PubMed, JSTOR, Dimension AI, and AJOL, using Medical Subject Headings (MeSH) terms for PubMed and refined for other databases. Additional searches were performed in Google Scholar and university repositories. Reference lists of eligible records were also checked for other relevant articles. Both peer-reviewed and grey literature were included. Search results were screened against predefined inclusion and exclusion criteria, and extraction was done using a data extraction form. Thematic analysis and synthesis were carried out with evidence presented as narrations and summarised in tables.

A total of 15 studies met the inclusion criteria for this review, highlighting socio-cultural factors and interventions affecting TB control. The main socio-cultural factors identified include health literacy, cultural beliefs, socio-economic factors, healthcare accessibility, and cultural practices. Additionally, stigma, financial constraints, reliance on traditional medicine, and inadequate healthcare resources were also identified as contributing factors. Effective interventions focused on community engagement, cultural adaptation, gender sensitivity, and improving accessibility to healthcare.

Socio-cultural factors significantly affect the effectiveness of TB control efforts. Interventions that incorporate community engagement, cultural adaptation, and gender sensitivity are essential for overcoming barriers to care and improving treatment outcomes. Tailoring TB control programmes to address specific cultural contexts and ensuring accessibility and trust in healthcare systems are crucial steps in enhancing global TB control strategies.