A Biopsychosocial-Systems Analysis of the Tuberculosis Continuum: Integrating Diagnostic Technology, Clinical Management, Health Informatics, and Social Determinants from Detection to Reintegration

Abstract

Background: Tuberculosis (TB) management is characterized by a protracted patient journey through complex, often fragmented health systems. While the biomedical cascade—from screening to treatment—is well-described, critical gaps persist at the intersections of clinical practice, health information systems, and the social ecology of illness. The integration of health informatics within this continuum remains underexplored as a pivotal mediator of care quality and patient trajectory. Aim: This narrative review synthesizes interdisciplinary evidence to construct an integrated model of the TB patient pathway. Methods: A comprehensive literature analysis was conducted across PubMed, Scopus, CINAHL, IEEE Xplore, and Sociological Abstracts (2010–2024). Search terms included tuberculosis care cascade, health information systems, electronic health records, diagnostic delay, data interoperability, social stigma, and structural vulnerability. Results: The analysis reveals that advances in rapid molecular diagnostics and digital radiology are frequently undermined by weak health information systems that fail to ensure timely result communication and care coordination. Nursing-led adherence support is critical but often operates without integrated patient data. Sociological factors, particularly stigma and economic precarity, function as systemic barriers exacerbated by informational gaps. Health informatics emerges not merely as a tool for surveillance but as a crucial infrastructure for linking diagnostic, clinical, and social support services. Conclusion: Effective TB care requires a paradigm shift toward a digitally enabled, person-centered continuum. This necessitates interoperable health information systems that unify diagnostic, therapeutic, and social data, empowering providers and patients while mitigating structural vulnerabilities. Future programs must co-design technological and social interventions to bridge the persistent divides between data, care, and context.

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