Implementation of Tuberculosis Preventive Therapy: A Scoping Review

This scoping review aims to map the evidence on the implementation of tuberculosis preventive therapy (TPT) in global TB elimination efforts, focusing on barriers, enablers, and practical strategies. A systematic search of Scopus, PubMed, and ScienceDirect yielded 919 studies, 20 of which met the inclusion criteria. The findings highlight persistent barriers across multiple levels. Issues pertaining to patients include stigma, low risk perception, and concerns about side effect. Limited human resources, disjointed TB/HIV services, medication stock-outs, and brittle supply chains are some of the obstacles faced by the health system. Insufficient funding and weak political commitment are indicators of policy gaps. Enablers include shorter regimens, integration into HIV or primary care programs, engagement of community health workers, and socioeconomic support. Practical strategies include the “test and treat” model, strengthened logistics systems, and caregiver empowerment for child contacts. Effective TPT implementation requires systemic action. Policymakers need to integrate TPT into universal health coverage (UHC), ensure sustainable financing, and secure reliable supply chains. Practitioners should prioritize short-course regimens, strengthen contact tracing, and provide structured patient support. Scaling up TPT depends on aligning regimen optimization, community engagement, workforce training, and political commitment to accelerate progress toward TB elimination.