{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T03:40:31Z","timestamp":1792208431113,"version":"4.4.0"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tuberculosis (TB) remains a major global health challenge, particularly in low\u2010 and middle\u2010income countries (LMICs). Community health workers (CHWs) are widely deployed to enhance TB care delivery, yet their roles, implementation models and contextual determinants have not been comprehensively synthesized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically review CHW\u2010led TB interventions in LMICs and to examine contextual determinants influencing implementation and effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was conducted following PRISMA 2020 guidelines. PubMed, Scopus and Web of Science were searched for studies published up to 31 December 2025. Quantitative, qualitative and mixed\u2010method studies evaluating CHW\u2010led TB interventions in LMICs were included. Study quality was appraised using Joanna Briggs Institute tools. Data were synthesized thematically and mapped to the Consolidated Framework for Implementation Research (CFIR). Findings were organized according to intervention models (community\u2010based DOT, family\u2010supported care and digital\/hybrid approaches).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ten studies were included: nine from Sub\u2010Saharan Africa (Ethiopia, Rwanda, Cameroon, Uganda and South Africa) and South\/Southeast Asia (Indonesia, India, and Vietnam), and one multi\u2010country analysis of TB\u2010REACH projects. CHWs contributed to health education, treatment adherence support, active case finding and system navigation. Implementation models varied across community\u2010based DOT, family\u2010supported and digital\/hybrid approaches. Effectiveness was influenced by patient knowledge, social stigma, CHW training and integration into health systems. Several studies reported improvements in treatment adherence and case detection, including one large Ethiopian pre\u2013post study reporting treatment success improvement from 76% to 95%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CHWs are critical in TB care in LMICs, but effectiveness is context\u2010dependent. Strengthening CHW capacity, culturally responsive implementation and systematic evaluation frameworks are essential. Evidence from comparative and implementation studies suggests that hybrid and digitally supported models show promise for improving scalability and coverage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.70225","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:51:55Z","timestamp":1792205515000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Roles and Implementation of Community Health Worker\u2013Led Interventions in Tuberculosis Care in\n                    <scp>Low and Middle\u2010Income Countries<\/scp>\n                    : A Systematic Review"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6785-0008","authenticated-orcid":false,"given":"Donatus Korbianus","family":"Sadipun","sequence":"first","affiliation":[{"name":"Faculty of Nursing Universitas Airlangga  Surabaya Indonesia"},{"name":"Faculty of Health Sciences Universitas Nusa Nipa  Maumere Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7988-9196","authenticated-orcid":false,"given":"Ferry","family":"Efendi","sequence":"additional","affiliation":[{"name":"Faculty of Nursing Universitas Airlangga  Surabaya Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0877-8506","authenticated-orcid":false,"given":"Violin Irene","family":"Ninef","sequence":"additional","affiliation":[{"name":"Faculty of Nursing Universitas Airlangga  Surabaya Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Global Tuberculosis Report 2024","author":"WHO","year":"2024"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939\u2010021\u201001615\u2010y"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0001482"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12961\u2010015\u20100001\u20103"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0004596"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748\u20105908\u20104\u201050"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102288\u20108\u201045"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh\u20102025\u2010021339"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12960\u2010022\u201000708\u20101"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1478\u20104491\u201012\u201018"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh\u20102017\u2010000390"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(23)00430\u20108"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.5588\/pha.17.0026"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/tropicalmed9040075"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010020\u201009042\u20104"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","unstructured":"T.Garg V.Panibatla J. P.Carel A.Shanta M.Bhardwaj andM.Brouwer \u201cCan Patient Navigators Help Potential TB Patients Navigate the Diagnostic and Treatment Pathways? An Implementation Research From India \u201d(2021).","DOI":"10.3390\/tropicalmed6040200"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.11.04042"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.70225","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tmi.70225","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.70225","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:51:57Z","timestamp":1792205517000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.70225"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,16]]},"references-count":18,"alternative-id":["10.1111\/tmi.70225"],"URL":"https:\/\/doi.org\/10.1111\/tmi.70225","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,16]]},"assertion":[{"value":"2026-04-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"tmi.70225"}}