Facilitators and barriers to tuberculosis diagnosis and treatment in India: a qualitative meta-synthesis protocol

Tuberculosis is a chronic infectious disease caused by bacteria Mycobacterium tuberculosis complex. We propose to collate and synthesize various facilitators and barriers to tuberculosis diagnosis and treatment in India by adopting a method of qualitative evidence synthesis. The protocol has been prepared adhering to the PRISMA-P guidelines. Primary studies on qualitative research and mixed methods on diagnosis and treatment of tuberculosis in India which are published in India from January 2000 to January 31st 2025 in English will be included. Two pass two stage screening will be adopted, with adjudication by third reviewer. Electronic databases such as MEDLINE, SCOPUS, EMBASE, Web of Science, ProQuest will be searched, along with gray literature. We will be scoping the website of Central TB division as a source of grey literature. We will be using Critical Appraisal Skills Program (CASP) Qualitative Research Checklist which is based on ten criteria for thematic synthesis of studies. We will be importing the findings to suitable data analysis software. We will be presenting the findings as narratives, categories and themes recovered from primary studies in Qualitative Meta-synthesis. The written synthesis of qualitative research will follow “Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ)”. GRADE–CERQual method of assessment will be used to assess confidence in the evidence of the qualitative research. The critical themes on facilitators and barriers which will be developed in this study will help to plan context specific interventions under National Tuberculosis Elimination Program to accelerate efforts towards the target of tuberculosis elimination in India.