Social Determinants and Interventions in Tuberculosis Control
Summary
Despite advances in diagnostics and treatment, tuberculosis persists as a public health challenge, largely because social circumstances shape both exposure and outcomes. Poverty, food insecurity and overcrowded living conditions facilitate transmission, while malnutrition and limited education undermine immune response and health-seeking behaviour. Financial hardship often forces patients to interrupt therapy, leading to drug resistance and poorer prognoses. Stigma, gender inequality and co-existing conditions such as HIV further compound barriers to care. In response, multisectoral interventions have emerged that combine cash transfers, nutritional supplements, housing support, community engagement and psychosocial counselling. Such measures aim to alleviate catastrophic health expenditures, promote adherence and address the broader social drivers of disease. Community-based models, involving trained health workers and tailored digital tools, have demonstrated increased treatment completion in marginalised groups. Success hinges on political commitment, sustained funding and cross-departmental collaboration to embed social protection within national tuberculosis programmes. By integrating socioeconomic support with biomedical strategies, policy makers can advance towards elimination targets while fostering equity and resilience in affected populations.
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Social Determinants and Interventions in Tuberculosis Control publication trend
The graph below shows the total number of articles in social determinants and interventions in tuberculosis control across all publications each year (not limited to Nature Index journals).
Technical terms
Social determinant: A socioeconomic or environmental factor that influences the risk of infection, progression and outcome of disease.
Catastrophic costs: Health-related expenses that exceed a defined proportion of household income, leading to financial crisis or impoverishment.
Social protection: Programmes and policies designed to reduce poverty and vulnerability by providing direct transfers, subsidies or services to those in need.
Psychosocial support: Interventions addressing both psychological wellbeing and social needs, including counselling, peer support and material assistance.
References
- Achieving universal social protection for people with tuberculosis. The Lancet Public Health (2024).
- Psychosocial support interventions to improve treatment outcomes for people living with tuberculosis: a mixed methods systematic review and meta-analysis. EClinicalMedicine (2023).
- Social protection as a right of people affected by tuberculosis: a scoping review and conceptual framework. Infectious Diseases of Poverty (2023).
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