Community-Based Interventions to Improve Tuberculosis Treatment Outcomes: A Meta-Analysis

• Community-aligned and digital interventions significantly improve TB treatment completion (pooled OR = 1.11; 95% CI: 1.02–1.20). • Social determinants—including food security, economic stability, and health literacy—substantially moderate treatment outcomes. • Integrating behavioural and socioeconomic support into routine TB programmes enhances programme resilience across diverse healthcare settings. More than a century of medical progress has not reduced tuberculosis (TB) as a leading global health threat. The challenge is not drug availability but treatment completion. The 10.7 million new cases and 1.23 million deaths reported in 2024 underscore that biomedical solutions alone are insufficient. Recovery depends on both medication and the social contexts patients face. Digital and community-led interventions aim to close this gap, yet a rigorous synthesis of their pooled effectiveness remains unavailable. We searched PubMed, Scopus, Web of Science, Google Scholar, Dimensions, the Cochrane Library, and ThaiJO for records from 2021 to 2025. Two reviewers independently assessed study quality via JBI tools. A random-effects model was applied. Pooled odds ratios and 95% confidence intervals were computed in JASP (version 0.19). We identified 17,208 records and ultimately included 20 controlled trials (n = 76,757 participants). Using restricted maximum likelihood estimation in a random-effects framework, community-aligned and digital interventions improved the likelihood of TB treatment completion (pooled OR = 1.11; 95% CI: 1.02–1.20; p = 0.018). Between-study heterogeneity was high (Q = 90.24; p < .001; τ² = 0.02), yet the direction of effect was consistently positive across settings. TB treatment efficacy extends beyond pharmacological potency; recovery is substantially determined by patients’ social stability, food security, and capacity to maintain adherence. Effective TB control must therefore integrate socioeconomic support alongside medical regimens to achieve meaningful outcomes.