Responding to a surge in new tuberculosis (TB) cases among migrants from high-incidence countries, low-incidence European nations have heeded World Health Organization recommendations by implementing TB screening in this population. This review aims to synthesise evidence on current screening strategies for active TB and latent tuberculosis infection (LTBI) in European high-income countries, and their main barriers and interventions. PubMed, Web of Science and Scopus were searched from March to April 2023, including articles in English, published in the last decade, pertaining to screening strategies for active TB or LTBI in Europe focused on migrants, excluding those exclusively composed of refugees, asylum seekers or other migrant populations. 32 studies fit the criteria. Screening in migrants varies between countries regarding timing, population, screening location and diagnosis. Furthermore, some barriers prevent migrants from benefiting from screening, namely physical, cultural and professional barriers. Additional research is needed to determine the patterns through which regular migrants adhere to current screening strategies in European countries.

People with or affected by tuberculosis (TB) experience complex social and cultural constraints that may affect treatment outcomes by impeding access to proper care or by hindering treatment adherence. Low levels of health literacy which leads to inadequate disease information; stigma, discrimination and other forms of prejudice that may result in marginalisation and ostracisation; and socioeconomic vulnerabilities that hamper one's capacity to access essential goods or increase the risk of exposure to the disease are some of the barriers highlighted. These complex hurdles are also disproportionately felt by people with or affected by TB due to gender-related inequalities that need to be properly addressed. Additionally, TB prevention and care should encompass interventions aimed at improving and promoting mental health, given that mental unhealth may further thwart treatment adherence and success. A multifaceted and multidisciplinary approach to TB is required to answer these complex barriers.

Background: Tuberculosis (TB) remains a significant global health challenge despite ongoing control efforts, particularly in the context of drug-resistant TB (DR-TB), where treatment success rates remain low, underscoring the need for new therapeutic options. This review synthesises current evidence, since the publication of the World Health Organization guidelines in 2022, on the safety and efficacy of existing and new regimens for drug-susceptible TB (DS-TB) and DR-TB in adults and children.Methods: A comprehensive search was performed across three databases for studies published between January 2022 and February 2024, focusing on current and new TB treatment regimens. Additional backward and forward citation searches were conducted to identify relevant literature.Results: 35 studies were included, evaluating the efficacy, safety and economic impact of new oral regimens for DS-TB and DR-TB. Regimens based on bedaquiline or delamanid demonstrated high success rates and good tolerability. The BPaLM (bedaquiline, pretomanid, linezolid and moxifloxacin) regimen was more effective and safer than the standard care, while shorter DR-TB regimens reduced costs and increased success rates. However, shorter regimens for DS-TB were associated with increased drug costs. Though limited, paediatric studies suggest that shorter, safer regimens may benefit children.Conclusion: Evidence supports the adoption of shorter treatment regimens for both DR-TB and DS-TB to improve safety, effectiveness and cost-effectiveness, particularly in resource-limited settings.

Patient-reported outcomes (PROs) play a crucial role in understanding the impact of tuberculosis (TB) on both individuals and communities. Despite advances in TB treatment, conventional outcome definitions often overlook essential components of people with TB's experiences, leading to disparities in treatment understanding. The incorporation of PROs in TB scientific research can help bridge the gap between the health system and people's needs and expectations. PROs can offer valuable insights into non-observable constructs like health literacy, self-efficacy and overall wellbeing, contributing to the comprehensive assessment of diagnosis, treatment and research end-points. Participatory community approaches, such as Community-Based Participatory, emphasise the engagement and involvement of relevant stakeholders in designing interventions tailored to their needs. Key stakeholders, including healthcare professionals, researchers, clinical trial investigators, public health officials, and community health workers, TB survivors and people with TB, can play a vital role in promoting patient-centred care and engaging directly with the TB-affected community. An increased and cross-collaborative effort for the inclusion of PROs in TB research can entail their potential role in developing effective treatment regimens and promoting adherence, while maximising community engagement and improving outcomes for those affected by TB.

Language plays a crucial role in shaping discourses and responses related to disease, particularly tuberculosis (TB). Stigmatising language and attitudes surrounding TB can lead to discrimination and marginalisation of affected individuals, creating barriers to seeking proper diagnosis and treatment. The terminology used to describe TB-affected individuals can be disempowering and criminalising, reinforcing an “othering” of those affected. To combat this, engaging with TB-affected communities is essential to co-construct a neutral and inclusive vocabulary that respects the dignity of individuals and fosters empathy and support. Thus, an inclusive language approach empowers affected individuals as active participants in their health management, encouraging open communication and the development of support networks. By adopting a neutral and inclusive language system, healthcare providers and communities can work together to remove unnoticed hurdles and align with the World Health Organization's TB care and prevention goals.

Despite global efforts to end tuberculosis (TB), slow declines in incidence and mortality rates persist, partly due to entrenched social and structural challenges. TB-related stigma is a critical barrier to effective TB prevention and treatment. However, existing frameworks often overlook broader structural and intersectional influences, underscoring the need for a comprehensive analysis of the social and structural factors influencing TB-related stigma. We aimed to (1) identify risk and protective factors influencing TB-related stigma and (2) examine how cultural, social, and economic determinants shape stigma experiences among people with TB. A systematic search was conducted across PubMed, SCOPUS, Web of Science, APA PsycInfo, and Sociology Source Ultimate. Studies were included if they (a) involved human participants, (b) were published in the last decade, and (c) reported stigma experiences influenced by social, economic, or environmental determinants. A total of 43 studies were included. Key determinants associated with higher TB-related stigma included lower educational attainment, rural residency, low income, gender, and specific mental health conditions. Cultural perceptions of TB, healthcare system interactions, and the dual stigma associated with HIV co-infection significantly exacerbated TB-related stigma experiences. Factors such as social support, patient-provider communication, and prior TB experience emerged as protective against stigma. Findings underscore TB-related stigma's complex intersection with social and structural determinants, highlighting gaps research, especially concerning standardised conceptual definitions and measurements. Addressing stigma is essential for improving TB care-seeking behaviours and health outcomes, particularly in low-resource settings where TB-related social isolation and discrimination are prevalent.