<![CDATA[Adherence to therapy is an essential component of successful pulmonary tuberculosis treatment, affecting patient recovery, prevention of drug resistance, and public health outcomes. Understanding compliance factors can guide interventions to improve treatment success rates. This systematic review explored the factors influencing adherence to therapy among tuberculosis patients, synthesizing evidence from various studies to understand the problem comprehensively. A systematic literature search followed PRISMA guidelines, including primary databases and screening for relevant studies. Twenty-four studies that met the inclusion criteria were analyzed. Data extraction and quality assessment were carried out to ensure the robustness of the findings. There were 2,729 articles identified according to the criteria, and 24 articles were obtained that analyzed several factors affecting patient with tuberculosis (PTB) therapy adherence, which were classified into individual, socioeconomic, and healthcare system domains. Key individual factors include patient knowledge about TB, stigma, mental health challenges, and substance use. Socioeconomic barriers, such as financial constraints and limited social support, are particularly prominent. Health system factors, including accessibility, quality of provider-patient communication, and ease of care facilities, also significantly affect compliance. Addressing adherence to TB therapy requires a multi-faceted approach that combines patient education, socioeconomic support, and healthcare system improvement. Targeted interventions based on these findings are critical to improving treatment outcomes and reducing TB-related health disparities]]>
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