Not Sick, Yet Treated: Barriers and Facilitators to Tuberculosis Preventive Treatment Uptake Among Household Contacts of Tuberculosis Patients in Moulvibazar District, Bangladesh

Introduction Preventing tuberculosis (TB) through TB Preventive Treatment (TPT) is an essential component of TB control and elimination. In recent years, many countries including Bangladesh, have revised their national programs to extend TPT to household contacts of TB patients. However, coverage remains well below the target, and evidence remains limited on context-specific barriers and facilitators. This study aimed to explore the barriers and facilitators to TPT uptake among household contacts in Bangladesh. Methods This study followed an exploratory qualitative approach. The setting was Moulvibazar district, Bangladesh. Qualitative data were collected through key-informant interviews with health providers and in-depth interviews with household contacts, and participants were selected through purposive sampling. Thematic analysis was used to explore the factors influencing TPT uptake. Results Perceived lack of need for treatment among household contacts and side effects of TPT medicines emerged as major barriers. Stigma associated with TB and resource shortage at the health facility level further hampered uptake. Counseling on the importance of TPT and its possible side effects, along with public awareness campaigns, facilitated TPT uptake by addressing household contacts concerns. Perceived risk of TB, free TPT services, support from family members, and health providers positive attitudes also supported uptake. Conclusion Addressing household contacts concerns about the need for treatment and potential side effects, along with strengthening health facility capacity, is required for improving TPT uptake. Both individual counseling and mass awareness campaigns can help address these concerns and facilitate uptake. These strategies may help increase TPT coverage in Bangladesh and beyond, contributing to global TB elimination efforts.