Obstacles and possibilities in guaranteeing tuberculosis treatment for homeless people: systematic review and meta-synthesis

We aimed to synthesize the evidence from qualitative studies on the experiences of tuberculosis treatment among people living on the streets. We conducted a systematic review with meta-synthesis, searching for studies in ten databases from January to June 2023. We identified 3,801 publications, five of which were included in the study. This meta-synthesis reflects the barriers faced by the people living on the streets during tuberculosis treatment. These barriers originate from drug use, prejudice, lack of a support network, difficulties in accessing health establishments, and the low prioritization of treatment. Furthermore, there are issues with service resolution and accessibility, which often neglect the unique needs of these individuals. In contrast, comprehensive and humanized care, decentralized to primary health care, characterized by coordinated practices and family support, promotes access to treatment and strengthens connections with healthcare teams.