Risk Factors For Tuberculosis Treatment Failure in Five High Tuberculosis Burden Countries: A Scoping Review
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Treatment failure for tuberculosis (TB) remains a serious public health problem, particularly in countries with high TB incidence, since it leads to drug-resistant TB, higher mortality rates, and persistent transmission. This comprehensive research, conducted in five countries with large tuberculosis burdens China, India, Indonesia, Pakistan, and the Philippines aims to identify and define risk factors for treatment failure in adult patients with drug-sensitive tuberculosis (DS-TB) and drug-resistant tuberculosis. The study used a review technique based on the Joanna Briggs Institute (JBI) criteria and the Population-Concept-Context (PCC) framework. The population consisted of adult tuberculosis patients, the concept was on risk variables linked with treatment failure, and the environment was confined to the five high-burden nations. Literature searches were undertaken in PubMed, Scopus, and EBSCOHost for studies published between 2015 and 2025, and study selection followed the PRISMA-ScR standards. The final analysis includes 19 studies that fulfilled the inclusion criteria. Clinical variables accounted for 73.7% of all identified risk factors, followed by demographic factors (68.3%) and microbiological factors (57.9%). Behavioral and social aspects were recorded in 31.6% and 26.3% of studies, respectively. Several risk variables were documented in numerous nations, however the prevailing risk profiles differed by country. Older age and malnutrition were prevalent in China; male sex and underweight status in India; older age, low treatment compliance, and limited tuberculosis-related knowledge in Indonesia; pulmonary cavitation, prior tuberculosis history, and drug resistance in Pakistan; and working-age characteristics, positive sputum smear results, and treatment discontinuation in the Philippines. These data show that, whereas some similar drivers of treatment failure exist in high-burden nations, the relative importance of specific risk variables differs by country. As a result, TB control programs should mix integrated and patient-centered methods with country-specific treatments tailored to the predominant risk profiles observed in each context.
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