Cultural factors influencing tuberculosis prevention and treatment in Sub-Saharan Africa: A scoping review
1
Public Health, University of Free State, Bloemfontein, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Tuberculosis (TB) remains a major public health challenge in Sub-Saharan Africa, despite the availability of effective diagnostic tools and treatment. Evidence suggests that cultural beliefs, social norms, and religious practices significantly influence TB prevention, health-seeking behaviour, and treatment adherence. However, these cultural factors remain underexplored and inadequately integrated into TB control programmes.
METHODS:
A scoping review was conducted following the Arksey and O’Malley framework and reported in line with the Preferred Reporting Items for Systematic Reviews (PRISMA-ScR). Electronic databases including PubMed, MEDLINE, Scopus, Web of Science, and Google Scholar were searched. Grey literature was obtained from World Health Organization reports and national TB programme documents. Studies published in English between 2020 and 2025 that focused on cultural influences on TB prevention, care-seeking, or treatment adherence in Sub-Saharan Africa were included.
RESULTS:
Thirty-three studies met the inclusion criteria. The studies were conducted across multiple Sub-Saharan African countries, including South Africa, Uganda, Ethiopia, Nigeria, Mozambique, Malawi, Kenya, Madagascar and Ghana. Key themes identified included cultural beliefs and traditional healing practices, stigma, silence and discrimination, gender and power dynamics, religion, faith and spiritual healing, and knowledge awareness and health literacy. Across settings, cultural interpretations of TB, reliance on traditional and faith healers, stigma linked to TB, gendered barriers to care, and persistent knowledge gaps were found to significantly shape health-seeking behaviour and treatment adherence.
CONCLUSIONS:
The findings demonstrate that cultural factors play a critical role in shaping TB prevention and treatment outcomes in Sub-Saharan Africa. TB control efforts that fail to engage with cultural beliefs, community structures, and faith systems risk limited effectiveness. Integrating culturally responsive approaches into TB programmes may enhance acceptability, improve adherence, and contribute to reducing the TB burden in high-burden settings.
Tuberculosis (TB) remains a major public health challenge in Sub-Saharan Africa, despite the availability of effective diagnostic tools and treatment. Evidence suggests that cultural beliefs, social norms, and religious practices significantly influence TB prevention, health-seeking behaviour, and treatment adherence. However, these cultural factors remain underexplored and inadequately integrated into TB control programmes.
METHODS:
A scoping review was conducted following the Arksey and O’Malley framework and reported in line with the Preferred Reporting Items for Systematic Reviews (PRISMA-ScR). Electronic databases including PubMed, MEDLINE, Scopus, Web of Science, and Google Scholar were searched. Grey literature was obtained from World Health Organization reports and national TB programme documents. Studies published in English between 2020 and 2025 that focused on cultural influences on TB prevention, care-seeking, or treatment adherence in Sub-Saharan Africa were included.
RESULTS:
Thirty-three studies met the inclusion criteria. The studies were conducted across multiple Sub-Saharan African countries, including South Africa, Uganda, Ethiopia, Nigeria, Mozambique, Malawi, Kenya, Madagascar and Ghana. Key themes identified included cultural beliefs and traditional healing practices, stigma, silence and discrimination, gender and power dynamics, religion, faith and spiritual healing, and knowledge awareness and health literacy. Across settings, cultural interpretations of TB, reliance on traditional and faith healers, stigma linked to TB, gendered barriers to care, and persistent knowledge gaps were found to significantly shape health-seeking behaviour and treatment adherence.
CONCLUSIONS:
The findings demonstrate that cultural factors play a critical role in shaping TB prevention and treatment outcomes in Sub-Saharan Africa. TB control efforts that fail to engage with cultural beliefs, community structures, and faith systems risk limited effectiveness. Integrating culturally responsive approaches into TB programmes may enhance acceptability, improve adherence, and contribute to reducing the TB burden in high-burden settings.
| eISSN: | 2654-1459 |
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