Factors associated with unfavorable outcomes in tuberculosis treatment in homeless people: a systematic review

Tuberculosis (TB) remains a major public health problem, especially among vulnerable populations such as homeless people. This group is at higher risk of illness, delayed diagnosis, and treatment abandonment. This systematic review aimed to identify factors associated with unfavorable TB outcomes in HP. The search, conducted in PubMed and Embase according to PRISMA guidelines, resulted in seven studies included. The main risk factors identified were male sex, low education, alcohol and drug use, previous TB, and HIV coinfection. Pulmonary forms predominated, with high abandonment rates. It is concluded that homelessness is a determinant of therapeutic failure, reinforcing the need for strategies such as directly observed therapy (DOT).