SynthesisRevista da Escola de Enfermagem da U S P2026
Tuberculosis in the South America's homeless: a systematic review of social determinants, control strategies and health equity.
Synthesis in Revista da Escola de Enfermagem da U S P, 2026. 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
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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.
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Authors and funding
7 authors.
Funding
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Abstract
introductionTuberculosis (TB) remains a major public health problem in South America, disproportionately affecting vulnerable populations, such as the homeless population (HP).
objectiveTo synthesize, through a systematic review with meta-synthesis, the scientific evidence on the relationship between tuberculosis and its social, individual, and programmatic determinants in the HP in South America, highlighting factors associated with treatment abandonment and mortality.
methodsScientific articles were searched in PubMed, EMBASE, LILACS, SciELO, Web of Science, and Cochrane databases, published in Portuguese, English, or Spanish between 2013 and 2023. Study selection was conducted independently by three reviewers, with consensus reached by a fourth when necessary. The process followed the protocols of the Cochrane Collaboration and the PRISMA flowchart, resulting in the inclusion of 27 studies.
resultsThe most frequent determinants were lack of social protection (85%) and extreme poverty (75%), both associated with high rates of treatment abandonment (average of 36%) and mortality (average of 14%). Reduced use of Directly Observed Therapy (DOT) and regional inequalities emerged as critical factors. The meta-synthesis indicated that alcohol and drug users had a 2.3 times higher risk of treatment abandonment, while TB-HIV coinfection increased mortality by up to threefold.
conclusionThe vulnerability of the HP to TB is strongly linked to social and programmatic factors. Intervention strategies should prioritize social protection, expansion of DOT, intersectoral policies, and approaches tailored to regional contexts in order to reduce inequalities and promote health equity.
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