Preventing Paediatric Tuberculosis: A systematic review and meta-analysis of tuberculosis preventive treatment uptake and completion in African children

This project is a systematic review and meta-analysis examining tuberculosis preventive treatment (TPT) uptake and completion among children and adolescent contacts in African countries. Children and adolescents exposed to pulmonary TB are a priority population for prevention, but global monitoring data provide limited visibility across the full TPT cascade, particularly where children are lost between identification, eligibility assessment, initiation, and completion. The purpose of this review is to synthesize evidence on TPT uptake and completion and to systematically examine family-, provider-, and organizational-level facilitators and barriers influencing progression through the TPT care cascade. Eligible studies include peer-reviewed articles published in English between January 2015 and September 2025 that report TPT initiation and/or completion among close child contacts under 15 years of age in African settings. Searches were conducted in PubMed, CINAHL, Embase, Web of Science, and Google Scholar. Data were extracted on study characteristics, population, TPT eligibility, initiation, completion, regimen, delivery approach, and reported facilitators and barriers. Quantitative synthesis uses random-effects meta-analysis of proportions, with stratified analyses by TPT delivery approach and regimen where data allow. Findings are expected to clarify the extent of TPT uptake and completion across African settings, identify implementation strategies associated with improved cascade progression, and highlight measurement and reporting gaps to inform future family-centred TB prevention services.