Health Literacy as A Determinant of Treatment Success in Multidrug Resistance Tuberculosis: A Systematic Review

<ns7:p>Background Multidrug-resistant tuberculosis (MDR-TB) remains a serious global health threat, with treatment success rates stagnating despite advances in therapy. Health literacy, defined as the ability to access, understand, evaluate, and apply health information, may play a role as a modifiable determinant of MDR-TB treatment success. Methods Two databases (PubMed and Scopus) were used following the PRISMA guidelines to find articles published between January 1st, 2015, and October 11st, 2025. A total of 231 records were identified and seven articles were included in this systematic review. Results Health literacy was operationalized via patient knowledge, counseling/education, self-care behaviors, communication, and digital adherence support, with outcomes capturing adherence, completion, attitudes, self-care, and literacy levels. Synthesis suggested a consistent directionality in which literacy-oriented strategies and communication-focused approaches aligned with improved adherence and programmatic indicators, while contextual and methodological heterogeneity limited cross-study comparability. Conclusion Available evidence supports health literacy as a promising, modifiable lever to enhance MDR-TB adherence and treatment success, particularly when addressed through multi-component, patient-centered strategies. Future work should use validated, multidomain literacy instruments and robust designs to quantify effects and guide scalable, literacy-sensitive MDR-TB programs.</ns7:p>