The engagement of Indigenous populations in tuberculosis control - with a focus on contact tracing: a scoping review.

Abstract

Objectives: Tuberculosis (TB) remains a major global public health concern that disproportionately affects Indigenous people. Contact tracing and early identification of those exposed to TB is essential for TB control. This study assesses the engagement of Indigenous populations for TB control against international and national TB guidelines.

Design: A scoping review was conducted using five databases: PubMed, EMBASE, Global Health, Web of Science, and Google Scholar. Medical Subject Headings (MeSH) were used depending on the search engine and functionality. Key search terms included 'Tuberculosis,' 'Contact tracing' and 'Indigenous population/people(s),' and Indigenous populations by name including Māori, Native American, Aboriginal, First Nations, Inuit, Torres Strait, American Indian, Alaska Native, Native Hawaiian and Pacific Islanders. Articles published between 1 January 2000 and 1 July 2024, in the English language, were included. Grey literature was examined for relevant guidelines on Indigenous engagement in TB control and articles were scored against key indicators found in the guidelines.

Results: Twenty-eight studies from eight countries were reviewed and assessed against five key indicators identified in the international guidelines and national guidelines. Many studies provided limited details on how they engaged with Indigenous populations, which resulted in low scores. No study met all five key indicators, and 32% did not meet any of the five indicators.

Conclusion: This review highlights the lack of consistency in the engagement of Indigenous populations in published TB control efforts, as well as differences between national TB guidelines. These findings underscore the urgent need to strengthen and align national guidelines with international standards as part of progress towards TB elimination.