ReviewThe Indian journal of medical research2025
Barriers to effective management of drug-resistant tuberculosis in India, insights into patient & health system challenges: An exploratory review.
Review in The Indian journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The emergence of drug-resistant tuberculosis (DR-TB), especially multi drug resistant tuberculosis (MDR-TB), is increasingly threatening the effectiveness of India's National TB Elimination Program (NTEP). This review seeks to analyse the patient and health system challenges concerning the management of DR-TB and seeks to find appropriate solutions to maximize the programmatic impact. A systematic literature search was carried out on PubMed, Embase, Scopus and Google Scholar for articles published between 2015 and 2024 focusing on the treatment challenges in India's MDR or extensive drug resistant (XDR) TB. Factors regarding care access, adherence to treatment, and systemic barriers were prioritised. We accepted qualitative, retrospective, and cross-sectional designs; clinical trials and non-English publications were excluded. We included 15 eligible studies thematically. The socioeconomic factors, barriers to access to care were paired with a stigma, low disease awareness and care responsibility at home. This was alongside a high pill burden and adverse drug effects. Alcoholism and psychosocial depression comorbidities with poorly supportive social environments further worsened adherence. Gaps in the health system included insufficient drug resistance testing, delay in diagnostics, a lack of healthcare personnel, inadequate referral chains, and inconsistent treatment regimens. Lack of streamlined referral pathways and non-standardised treatment regimens posed problematic operational challenges. Weak involvement from the private sector and lack of training and supervision of frontline workers also contributed to operational gaps. Policy gaps included limited program scope, inadequate funding, or lack of universal health coverage. While urban areas faced coordination issues with the private sector, rural areas contended with further delays in diagnostics. A comprehensive strategy is essential when dealing with patients with DR-TB in India. Aligning psychosocial support, enhanced funding, and multisector coordination with infrastructure and better access to conflicting diagnostics can improve local contexts and targets NTEP's TB elimination goals.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.