7.4.6. Substance abuse and late presentation to care

The review identified specific challenges of providing TB care to adolescents around substance abuse, late presentation to care and treatment adherence. Adolescence is a time when individuals may engage in reward-seeking and risk-taking behaviours, including substance use. This may increase the risk of developing TB disease, more severe disease or more unfavourable treatment outcomes. Further research is required to better understand how to co-manage TB and substance use in adolescents.

There was evidence suggesting high prevalence rates, advanced disease at the time of diagnosis and underdetection of TB in adolescents, but more data are needed on the risk of late presentation and underdiagnosis in specific settings.

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