Challenges in implementing preventive treatment for latent tuberculosis infection - a narrative review from provider and demand-side perspectives

Sep 28, 2026

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Preventive treatment for latent tuberculosis infection (LTBI) is a key measure to interrupt tuberculosis development, yet real-world implementation often falls short. This narrative review systematically identifies barriers to initiating and implementing LTBI preventive treatment worldwide by synthesizing evidence from demand-side and supply-side perspectives. Findings highlight low awareness, concerns about adverse effects, longer treatment duration, and uncertainty about effectiveness, alongside limited healthcare-worker knowledge, constrained resources, and low policy priority. Multidimensional interventions are recommended to improve acceptance and adherence and accelerate End TB implementation.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Background

Latent tuberculosis infection and rationale for preventive treatment

Methods

Evidence search and barrier extraction

Results

Demand-side barriers to acceptance and uptake

Supply-side barriers to implementation

Conclusion

TYPE Systematic Review PUBLISHED 17 December 2025 DOI 10.3389/fpubh.2025.1628218 OPEN ACCESS EDITED BY Stephen Henry Gillespie, University of St Andrews, United Kingdom REVIEWED BY Rakhi Gaur, All India Institute of Medical Sciences, Deoghar (AIIMS Deoghar), India Al Story, University College London, United Kingdom *CORRESPONDENCE Wei Wang [jfwwang@cdc.zj.cn](jfwwang@cdc.zj.cn)[ ](jfwwang@cdc.zj.cn)Bin Chen [bchen@cdc.zj.cn](bchen@cdc.zj.cn)[ ](bchen@cdc.zj.cn)Jianmin Jiang [jmjiang@cdc.zj.cn](jmjiang@cdc.zj.cn) †These authors have contributed equally to this work and share last authorship RECEIVED 14 May 2025 REVISED 27 November 2025 ACCEPTED 30 November 2025 PUBLISHED 17 December 2025 CITATION Ling Y, Chen S, Zhang Y, Wu Q, Yang K, Luo D, Li Y, Zhou Y, Wang W, Chen B and Jiang J (2025) Challenges in implementing preventive treatment for latent tuberculosis infection: a narrative review from provider and demand-side perspectives. Front. Public Health 13:1628218 . doi: 10.3389/fpubh.2025.1628218 COPYRIGHT © 2025 Ling, Chen, Zhang, Wu, Yang, Luo, Li, Zhou, Wang, Chen and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Challenges in implementing preventive treatment for latent tuberculosis infection: a narrative review from provider and demand-side perspectives Yuxiao Ling 1, Songhua Chen 2,3, Yu Zhang 2,3, Qian Wu 2,3, Ke Yang 2, Dan Luo4, Yang Li 5, Yiqing Zhou4, Wei Wang 2,3*†, Bin Chen 2,3*† and Jianmin Jiang 2,3*† 1School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China, 2Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China, 3Zhejiang Key Lab of Vaccine, Infectious Disease Prevention and Control, Hangzhou, Zhejiang, China, 4School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China, 5School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China Background: Preventive treatment is an important measure to interrupt the development of tuberculosis (TB) in people with latent tuberculosis infection (LTBI), which is among the key elements of TB prevention and control in the future. However, the implementation of preventive treatments has been affected by various factors and has fallen far short of expectations. Therefore, this study aims to systematically identify barriers to initiating and implementing LTBI preventive treatment globally from both demand-side and supply-side perspectives, providing targeted evidence to advance the End TB Strategy. Methods: We systematically searched PubMed and Embase for articles related to preventive treatments. All included articles were peer-reviewed Englishlanguage articles published between January 1, 2010, and August 31, 2024. The barriers affecting the initiation and implementation of preventive treatment were extracted from eligible articles and summarized from the two perspectives of supply side and demand side. Results: Low levels of awareness, concerns about adverse effects, longer treatment periods, and uncertainty regarding the effectiveness of treatment may influence the acceptance of preventive treatment. Furthermore, inadequate knowledge and experience of healthcare workers, limited human and material resources, and low policy priorities may partially hinder the implementation of preventive treatments. Conclusion: Multidimensional interventions need to be developed to improve acceptance and adherence to preventive treatment and accelerate the implementation. This

FAQs

What is the purpose of preventive treatment for LTBI according to the document?

It aims to eliminate Mycobacterium tuberculosis in a resting state in people with LTBI and reduce the risk of later reactivation.

Which demand-side factors may reduce acceptance of preventive treatment?

Low awareness, concern about adverse effects, longer treatment periods, and uncertainty about treatment effectiveness can influence acceptance.

Which supply-side issues can hinder implementation of preventive treatment?

Inadequate healthcare-worker knowledge and experience, limited human and material resources, and low policy priorities may partially hinder implementation.

Sep 28, 2026

Uploaded by Putri