Table 1.

Research Gaps on the Social Determinants of TB Treatment Adherence in Children and Adolescents and Young Adults

Structural/Community Factors

• Pathways of how exposure to violence creates barriers to adherence

• Interventions to address TB-related stigma and inequitable gender norms for children and AYA

• Role of social protection programs and peer support networks for children and AYA with TB

Health System Factors

• Child and AYA needs and preferences to develop age-appropriate services

• Impact of fixed-dose combinations and all-oral MDR TB regimens on adherence

• Influence of novel adherence monitoring tools, including digital adherence technologies, on adherence

• Effect of decentralized TB care on adherence

Household/Caregiver Factors

• Influence of TB illness in additional household members, including the caregiver of the child/AYA, on adherence

• Interventions to address household material-need insecurities to improve adherence

Individual Factors

• Influence on adherence of caregiver and patient knowledge and attitudes about TB disease and treatment

• Effect of developmental changes during adolescence and young adulthood on adherence, including a shifting emphasis from family relationships to peer relationships

• Role of self-efficacy to support TB treatment adherence

• Interventions to support mental health during TB treatment

Other Research Needs

• Wider geographic representation

• Additional studies on adherence to TB disease treatment in children

• Greater inclusion of older adolescents

Abbreviations: AYA, adolescents and young adults; MDR, multidrug-resistant; TB, tuberculosis.