How do adult migrants with active TB adhere to care in high-income countries? A systematic review

BACKGROUND In high-income countries (HICs), adult migrants treated for active TB could face barriers that hinder adherence to the TB care pathway. OBJECTIVE To identify the specific features of adherence to the TB care process among adult migrants in HICs. METHODS Three researchers independently selected empirical studies on adult migrant's adherence to the TB care process published between 1 January 2010 and 1 November 2024 in MEDLINE, Embase, CINAHL, and PsycINFO. Outcomes included treatment adherence and retention in care. RESULTS Of 355 records screened, 24 studies met the inclusion criteria. All used quantitative designs, and most (67%, n = 16) were conducted in Europe. Among the four studies reporting statistically significant associations, all found that migrant status was linked to poorer adherence outcomes. Descriptions of migrant characteristics were limited: legal status appeared in only four studies, and none assessed migration motives. Several individual and structural barriers to adherence were identified. The year of arrival emerged as an informative variable, reflecting combined social determinants shaping care access and treatment continuity. CONCLUSION Adult migrants face substantial challenges in adhering to the TB care process in HICs. Future research should more precisely characterise this population, which is currently described in insufficient detail. .