SYSTEMATIC REVIEW article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Challenges in Implementing Preventive Treatment for Latent Tuberculosis Infection: A Narrative Review from Provider and Demand-Side Perspectives
Provisionally accepted
Yuxiao Ling1
Songhua Chen2
Yu Zhang2
Qian Wu2
Ke Yang2
Dan Luo3Yang Li4
Yiqing Zhou3
Wei Wang2*
Bin Chen2*
Jianmin Jiang2*- 1Ningbo University, Ningbo, China
- 2Zhejiang Center for Disease Control and Prevention (Zhejiang CDC), Hangzhou, China
- 3Hangzhou Medical College, Hangzhou, China
- 4Hangzhou Normal University, Hangzhou, China
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Background: Preventive treatment is an important measure to interrupt the development of tuberculosis (TB) in people with latent tuberculosis infection (LTBI), which is among the key elements of TB prevention and control in the future. However, the implementation of preventive treatments has been affected by various factors and has fallen far short of expectations. Therefore, this study aims to systematically identify barriers to initiating and implementing LTBI preventive treatment globally from both demand-side and supply-side perspectives, providing targeted evidence to advance the End TB Strategy. Methods: We systematically searched PubMed and Embase for articles related to preventive treatments. All included articles were peer-reviewed English-language articles published between January 1, 2010, and August 31, 2024. The barriers affecting the initiation and implementation of preventive treatment were extracted from eligible articles and summarized from the two perspectives of supply side and demand side. Results: Low levels of awareness, concerns about adverse effects, longer treatment periods, and uncertainty regarding the effectiveness of treatment may influence the acceptance of preventive treatment. Furthermore, inadequate knowledge and experience of healthcare workers, limited human and material resources, and low policy priorities may partially hinder the implementation of preventive treatments. Conclusions: Multidimensional interventions need to be developed to improve acceptance and adherence to preventive treatment and accelerate the implementation. This not only provides direction for future research but also provides a reference basis for clinical practice and policy development to accelerate the process of eliminating TB.
Keywords: adherence, Challenges, latent tuberculosis infection, Preventive treatment, review
Received: 14 May 2025; Accepted: 30 Nov 2025.
Copyright: © 2025 Ling, Chen, Zhang, Wu, Yang, Luo, Li, Zhou, Wang, Chen and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wei Wang
Bin Chen
Jianmin Jiang
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.