Background: Tuberculosis (TB) remains a major global health challenge, with patient non-compliance to the Directly Observed Treatment, Short-course (DOTS) therapy being a primary obstacle to effective control and a leading cause of drug resistance. Aim: This systematic review aims to synthesize existing evidence on the key factors influencing patient compliance with DOTS therapy to inform the development of more effective and patient centered interventions. Material and Methods: A comprehensive literature search was conducted across databases including PubMed, Scopus, CINAHL, and Google Scholar for studies published from 2015 to 2025. Data from primary research studies that examined factor affecting adherence were extracted and synthesized thematically,categorizing the determinants into socioeconomic, personal, behavioral, and healthcare system-related factors. Result: The review found that compliance is a complex issue driven by a combination of interconnected barriers. Key findings include the significant impact of low socioeconomic status (poverty and low education), negative personal and behavioral factors (substance use and poor health literacy), and systemic issues within the healthcare system (poor patient-provider relationships, lack of support, and inaccessible services). The synthesis underscores that patient centered care and community engagement are crucial facilitators of adherence. Conclusion: Achieving the goal of TB elimination requires a holistic, multi-sectoral strategy that addresses the clinical, social, and economic determinants of adherence. Effective interventions must be tailored to overcome these pervasive barriers and empower patients and communities.
Shareph et al. (Tue,) studied this question.
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