From Symptoms to Treatment: Patient Pathways and Delays in TB Care in LMICs

Tuberculosis is the leading cause of death attributable to a single infectious disease globally, with a disproportionate burden borne by low- and middle-income countries (LMICs). It has resulted in nearly double the deaths compared to HIV/AIDS. Over 10 million individuals are estimated to fall ill every year, with an upward trend observed since 2021. Despite the availability of effective diagnostics and curative treatment, delays in TB care, from the onset of symptoms to treatment initiation, continue to undermine disease control efforts. These delays are often shaped by complex and non-linear patient pathways involving multiple providers across public, private, and informal health sectors. Socioeconomic vulnerability, stigma, health system fragmentation, gender norms, and geographic barriers further compound these challenges. In LMIC settings, including India and other high-burden countries, understanding how patients navigate care-seeking pathways and where critical delays occur is essential to improving early diagnosis, treatment outcomes, and transmission control. A nuanced, context-sensitive examination of patient pathways is therefore central to achieving global TB elimination targets.This Research Topic aims to foster a comprehensive and interdisciplinary understanding of patient pathways and delays in TB care across LMICs. We aim to go beyond simple descriptions of delays to explore why they happen, where they are concentrated along the care pathway, and how health systems and social contexts influence patient experiences. This Research Topic seeks to highlight methodological innovations, including pathway mapping, systems thinking, mixed-methods approaches, and patient-centred frameworks, to understand the dynamic realities of the TB care cascade.Recent developments, such as molecular diagnostics, digital adherence technologies, public–private mix models, and community-based screening, present new opportunities to reduce delays, although their effectiveness in real-world settings varies widely. By gathering evidence from diverse LMIC contexts, this Research Topic aims to identify practical insights, policy-relevant solutions, and scalable strategies to shorten diagnostic and treatment delays. Ultimately, it strives to support more responsive, equitable, and patient-centred TB programmes that align with national TB elimination efforts and the global End TB targets.This Research Topic welcomes original contributions that examine patient pathways, delays, and care-seeking behaviour related to TB across various settings in LMICs, specifically focusing on the supply-side and demand-side factors that determine delays in TB care.Submissions may address, but are not limited to, the following themes:• Demand side or patient-related delays and supply side or the health systems delays• Patient journeys across public, private, and informal healthcare providers• Social determinants of TB across the care cascade• Stigma, trust, and lived experiences influencing delays• Innovations in pathway analysis, network mapping, and systems approaches• Policy, programmatic, and health system interventions to reduce delays• Comparative and multi-country analyses, including India-focused studies.We invite original research articles, systematic reviews, qualitative and mixed-methods studies, short communications, and policy or implementation-focused papers. Submissions from diverse disciplinary perspectives and country contexts are strongly encouraged.If you are interested in submitting or have any questions, please contact the journal email: tuberculosis@frontiersin.org. Topic editors: Janmejaya Samal, Jeremiah Chikovore Source: https://www.frontiersin.org/research-topics/78695/from-symptoms-to-treatment-patient-pathways-and-delays-in-tb-care-in-lmics