Systematic review of risk factors for nonadherence to TB treatment in immigrant populations

Trans R Soc Trop Med Hyg. 2016 May;110(5):268-80. doi: 10.1093/trstmh/trw025.

Abstract

Background: Foreign-born populations carry a significant TB burden in low-prevalence countries, composing over half of all cases in parts of Europe and North America. This study systematically reviewed evidence of risk factors for nonadherence to TB drug therapy in this group.

Methods: On 28 October 2013 MEDLINE, CINAHL, Embase, PsychINFO and ProQuest were systematically searched for studies examining adherence in foreign-born populations with TB. Grey literature and reference lists were hand-searched. Risk factor studies were selected for inclusion if they consisted of at least 95% foreign-born populations.

Results: Of 1761 studies identified in the search, 20 were included in the risk factor review. Undocumented immigration status, older age, and social risk factors were consistently correlated with nonadherence; gender, ethnicity, immigration time, education level, adverse side effects, and HIV status were inconsistently correlated; and behavioural risk factors and marital status were consistently not correlated.

Conclusions: This review emphasizes documentation status as a risk factor candidate for further investigation.

Keywords: Emigrants and immigrants; Medication adherence; Tuberculosis.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Antitubercular Agents / therapeutic use*
  • Emigrants and Immigrants*
  • Emigration and Immigration*
  • Europe
  • Humans
  • Latent Tuberculosis / drug therapy*
  • Medication Adherence*
  • North America
  • Risk Factors
  • Tuberculosis, Pulmonary / drug therapy*

Substances

  • Antitubercular Agents