Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol

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Psychosocial determinants such as stigma, depression and anxiety, alcohol and substance use, and social and family support are frequently implicated, yet evidence is scattered across disciplines, uses heterogeneous definitions and tools, and is seldom synthesized for policy and implementation. Materials and Method This scoping review aims to systematically map psychosocial determinants associated with pretreatment and on-treatment LTFU among people with DR-TB in South Africa, describe how these determinants and LTFU are defined and measured, identify contextual modifiers (e.g., HIV status, sex/age, province, urban–rural setting, decentralization, regimen era), and highlight evidence gaps and practical leverage points for intervention. The review will follow established scoping-review methodology and report per PRISMA-ScR following five steps: (1) defining the research question, (2) search strategy, (3) setting inclusion criteria, (4) extracting data, (5) assessing, summarizing, presenting findings and (6) Consultation. A comprehensive peer-reviewed literature search, including PubMed, Scopus, ScienceDirect, and Google Scholar, will be conducted by two independent reviewers. The review will span over eight weeks, focusing on studies in South Africa published in English language between 2010 and 2025. Article eligibility will be determined using a two-stage screening process with disagreements resolved through consensus and consultation of a third reviewer. The results of this review will be presented as tables, including a narrative synthesis of the findings. No meta-analysis is planned. Conclusion The review will deliver a policy-ready map of psychosocial risks and promising support for DR-TB retention in South Africa, informing the design and targeting of patient-support packages and outlining priorities for future evaluation and standardization of LTFU definitions and psychosocial measures. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/14-1440", "name": "Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant..." } } ] } Home Browse Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Hosu MC, Akapo OO and Ogbodu OM. Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol [version 1; peer review: 2 not approved] . F1000Research 2025, 14 :1440 ( https://doi.org/10.12688/f1000research.171890.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Study Protocol Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol [version 1; peer review: 2 not approved] Mojisola Clara Hosu https://orcid.org/0000-0002-0388-787X 1 , Olufunmilayo Olukemi Akapo 2 , Olubunmi Margaret Ogbodu https://orcid.org/0000-0002-2488-2963 3 Mojisola Clara Hosu https://orcid.org/0000-0002-0388-787X 1 , Olufunmilayo Olukemi Akapo 2 , Olubunmi Margaret Ogbodu https://orcid.org/0000-0002-2488-2963 3 PUBLISHED 24 Dec 2025 Author details Author details 1 Laboratory Medicine and Pathology, Walter Sisulu University Faculty of Health Sciences, Mthatha, Eastern Cape, 5100, South Africa 2 Laboratory Medicine and Pathology, Walter Sisulu University Faculty of Health Sciences, Mthatha, Eastern Cape, 5100, South Africa 3 Anaesthesiology and Critical Care, Walter Sisulu University Faculty of Health Sciences, Mthatha, Eastern Cape, 5100, South Africa Mojisola Clara Hosu Roles: Conceptualization, Data Curation, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Olufunmilayo Olukemi Akapo Roles: Data Curation, Methodology, Validation, Writing – Review & Editing Olubunmi Margaret Ogbodu Roles: Data Curation, Methodology, Supervision, Validation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background Drug-resistant tuberculosis (DR-TB) in South Africa continues to threaten TB control, with loss to follow-up (LTFU) at both pretreatment (diagnosed but not initiated) and on-treatment stages undermining program success. Psychosocial determinants such as stigma, depression and anxiety, alcohol and substance use, and social and family support are frequently implicated, yet evidence is scattered across disciplines, uses heterogeneous definitions and tools, and is seldom synthesized for policy and implementation. Materials and Method This scoping review aims to systematically map psychosocial determinants associated with pretreatment and on-treatment LTFU among people with DR-TB in South Africa, describe how these determinants and LTFU are defined and measured, identify contextual modifiers (e.g., HIV status, sex/age, province, urban–rural setting, decentralization, regimen era), and highlight evidence gaps and practical leverage points for intervention. The review will follow established scoping-review methodology and report per PRISMA-ScR following five steps: (1) defining the research question, (2) search strategy, (3) setting inclusion criteria, (4) extracting data, (5) assessing, summarizing, presenting findings and (6) Consultation. A comprehensive peer-reviewed literature search, including PubMed, Scopus, ScienceDirect, and Google Scholar, will be conducted by two independent reviewers. The review will span over eight weeks, focusing on studies in South Africa published in English language between 2010 and 2025. Article eligibility will be determined using a two-stage screening process with disagreements resolved through consensus and consultation of a third reviewer. The results of this review will be presented as tables, including a narrative synthesis of the findings. No meta-analysis is planned. Conclusion The review will deliver a policy-ready map of psychosocial risks and promising support for DR-TB retention in South Africa, informing the design and targeting of patient-support packages and outlining priorities for future evaluation and standardization of LTFU definitions and psychosocial measures. READ ALL READ LESS Keywords Drug-resistant tuberculosis, loss to follow-up, psychosocial determinants, stigma, mental health, depression, South Africa Corresponding Author(s) Mojisola Clara Hosu ( [email protected] ) Close Corresponding author: Mojisola Clara Hosu Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Hosu MC et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Hosu MC, Akapo OO and Ogbodu OM. Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol [version 1; peer review: 2 not approved] . F1000Research 2025, 14 :1440 ( https://doi.org/10.12688/f1000research.171890.1 ) First published: 24 Dec 2025, 14 :1440 ( https://doi.org/10.12688/f1000research.171890.1 ) Latest published: 24 Dec 2025, 14 :1440 ( https://doi.org/10.12688/f1000research.171890.1 ) Introduction Despite significant progress towards its eradication, tuberculosis (TB) continues to be the principal cause of death from a single infectious agent globally with 1.25 million fatalities in 2023. 1 In many developing nations, TB, a chronic, airborne infection, caused by Mycobacterium tuberculosis although treatable and preventable, continues to be a major cause of mortality. 2 – 4 This has become a worrisome trend in resource-constrained nations even with the availability of effective treatment for decades. 2 , 5 The Global TB report of the World Health Organization (WHO) estimated that 10.8 million people were affected by TB in 2023, with an incidence rate of 134 per 100,000 population and Africa alone reported the highest TB infections, accounting for 24%. 1 , 2 Approximately 5% of incident TB cases develop drug-resistant TB (DR-TB). 6 DR-TB develops either as a result of misuse of anti-TB medications or outright infection with a drug-resistant strain. 4 DR-TB is a significant public health challenge globally recognized by the WHO as a threat to achieving the End TB targets. 7 The DR-TB pandemic is characterized by high rates of morbidity, mortality, and poor treatment outcomes and is mainly concentrated in low and middle-income countries including Africa, where there are resource constraints and low TB treatment coverage. 8 DR-TB infected patients face significant economic and social costs and only 33% access quality care. The remaining proportion represents the missing patients otherwise known as loss to follow up (LTFU) and reaching them is a significant public health challenge. 9 LTFU contributes to poor outcomes, leading to continued disease transmission, development of further drug resistance, and increased mortality. Psychosocial determinants including stigma, depression, poverty, social isolation, and lack of family support are increasingly recognized as critical factors influencing LTFU. While several studies have explored these factors in various contexts, the evidence remains fragmented and scattered, necessitating a comprehensive mapping through a scoping review. Rationale for scoping review Drug-resistant tuberculosis (DR-TB) remains a significant public health concern in South Africa, with LTFU both pretreatment and on-treatment posing persistent challenges to treatment success. While recent policy and therapeutic advancements, such as the introduction of short all-oral regimens, aim to ease treatment burden, psychosocial barriers to care remain inadequately addressed. Evidence on factors like stigma, depression, substance use, and socioeconomic stressors is fragmented and inconsistently measured, limiting its utility for programmatic action. Given South Africa’s National TB Program’s call for patient-centered, evidence-based strategies, a scoping review is necessary to systematically map the psychosocial determinants of LTFU, clarify definitions and measurement tools, highlight contextual modifiers, and identify implementation gaps. This will support the development of targeted interventions and inform policy design to enhance retention in DR-TB care. Methodology Study design The proposed scoping review will utilize the Joanna Briggs Institute (JBI) methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines and checklist to enable us make use of literature across study designs and in both peer-reviewed and grey literature. 10 – 12 The study will be accomplished in six key phases ( Figure 1 ). 1. Defining the research question 2. Developing a search strategy 3. Delineating inclusion and exclusion criteria 4. Charting the data 5. Data extraction, analysis and presentation of the results 6. Consultation Figure 1. Six stages of conducting a scoping review. Stage 1: Defining the research question A well-crafted research question allows the exploration of appropriate literature, identifies gaps in knowledge, and the synthesis of evidence thus ensuring the systematic conduct of a scoping review. Hence, the following research questions will be answered in this scoping review: • What psychosocial determinants are associated with pretreatment and on-treatment LTFU among people with DR-TB in African settings? • How are these determinants defined, measured, and reported across study designs and programmatic eras (e.g., pre- vs. post-“short, all-oral” regimens)? • Where are the evidence gaps and what implementation strategies are suggested to address them? To match the study selection with the research issue, this study will employ the Population, Intervention, Comparison, Outcomes, and Timeline (PICOT) framework. As there is no comparator in the proposed scoping review, therefore a PIOT framework will apply. Table 1 displays the PIOT framework to be used in this investigation. The research will run for 8 weeks, from 1 November to 31 December 2025, and studies from 2010 to 2025 will be eligible. In December 2010, WHO convened a global consultation and issued its first policy recommending Xpert MTB/RIF for rapid detection of TB and rifampicin resistance, triggering country adoption and large-scale roll-out. South Africa planned national roll-out from 2011. This shift shortened diagnostic delays and altered patient pathways which are key drivers of pretreatment and on-treatment LTFU. This period captures the programmatic era of DR-TB care in South Africa when diagnostic, treatment, and service-delivery changes reshaped the psychosocial context of LTFU. The period also accounts for COVID-19 disruptions and recovery. The pandemic caused major interruptions to TB diagnosis and treatment in South Africa with partial recovery, thereafter, likely amplifying psychosocial and structural risks for LTFU; extending the window through 2025 allows inclusion of the post-pandemic recovery period and the National TB Recovery Plan trajectory. Table 1. PICOT framework for study selection. Criteria P-Population Adult patients aged 18-60 years undergoing treatment of TB, following diagnosis of TB I-Intervention Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients C-Comparison No comparison group O-Outcome Primary - Identification of psychosocial determinants (e.g., stigma, depression, substance use, social support) associated with LTFU among DR-TB patients. - Characterization of how LTFU and psychosocial determinants are defined and measured across studies. - Secondary outcomes. - Identification of contextual modifiers (e.g., HIV status, gender/age, geographic setting). - Identification of gaps in evidence and recommendations for future research or interventions. T- Timeline 2010 – 2025 Stage 2: Developing a search strategy The strategy will utilize a research-librarian-led electronic search strategy following reviewers’ careful consideration. A comprehensive search strategy will be developed using PubMed, Scopus, ScienceDirect, and Google Scholar electronic databases, an all-inclusive search strategy will be developed for peer-reviewed articles and gray literature search focusing on English-language studies published between 2010 and 2025. To allow for the inclusion of appropriate studies, the review team will ensure that curated combination of Boolean operators, keywords and search terms are employed in electronic databases search ( Table 2 ). Table 2. Initial electronic database search results on 20th September 2025. Electronic database Search strings Results PubMed “tuberculosis” [tw] OR “drug-resistant” [Mesh] OR “loss to follow-up” [tw] OR “default*” OR “treatment interruption” [tw] AND “psychosocial determinants” [tw] OR “stigma” [tw] OR “substance use” [tw] OR “social support” [tw] OR “poverty” [tw] OR “food insecurity” [tw] OR “transportation” [tw] AND “South Africa*” [tw] AND (2010/1/1:2025/9/20[pdat])) 2,744 ScienceDirect “tuberculosis” AND “drug-resistant” OR “psychosocial determinants” AND “South Africa 3 Scopus “tuberculosis” AND “drug-resistant” AND “psychosocial determinants” OR “stigma” AND “loss to follow up” AND “South Africa” 11 Google Scholar “Multi-drug tuberculosis” OR “loss to follow-up” OR default OR “treatment interruption” OR “substance use” OR “social support” AND “South Africa” 17,800 Stage 3: Study selection of eligible studies To ensure a systematic and transparent selection process, the PIOT framework will guide the title and abstract screening, with two reviewers (MCH and OOA) working independently. The selection of eligible studies as indicated in Table 3 is expected to be finalized within 8 weeks, in accordance with the PRISMA-ScR checklist. After retrieving all relevant records from the databases, duplicates will be removed using EndNote V.20 (Clarivate). The entire screening process will be conducted using the Covidence systematic review platform to support collaboration between reviewers and ensure consistency. Discrepancies at any stage will be resolved through discussion and, if necessary, consultation with a third reviewer (OMO) to reach consensus. The PRISMA-ScR flowchart will be used to document the study selection, detailing the number of records identified, screened and included. A blank PRISMA-ScR flowchart is shown in Figure 2 . Table 3. Inclusion and exclusion criteria. Inclusion criteria Exclusion criteria Studies reporting on DR-TB patients in English language. Studies reporting on other types of TB (e.g., drug-susceptible TB) or extrapulmonary TB. Studies exploring psychosocial determinants of LTFU, such as social support, stigma, mental health, housing, socioeconomic factors, and patient-provider relationships. Studies that do not address psychosocial factors or LTFU among DR-TB patients. Studies that report at least one psychosocial determinant linked to LTFU/retention (e.g., stigma, depression/anxiety/stress, substance/alcohol, use, beliefs/knowledge, self-efficacy, social/family/peer support, disclosure, gender norms; plus, closely linked social/structural stressors such as poverty, food insecurity, travel distance/costs, migration, homelessness, incarceration). Purely biomedical or pharmacologic predictors (e.g., mutations, drug levels) with no psychosocial link; studies of adherence proxies without an engagement/retention or LTFU outcome. Studies that report any measure of LTFU or disengagement/attrition/“default,” pretreatment (diagnosed but not initiated) or on-treatment (interruption after initiation); with retention measures clearly defined. Studies that do not report LTFU/retention/disengagement (e.g., only culture conversion, cure, or mortality without engagement outcomes). Studies carried out in any province in South Africa, including prisons, mines, refugee/internally displaced persons (IDP) settings, community-based models, primary/tertiary care. Multi-region studies if a South African subset is extractable. Studies conducted outside South Africa; global analyses without separable South African data. Quantitative (cohort, case-control, cross-sectional, quasi-experimental, RCTs if they report relevant outcomes); Qualitative (interviews/focus group discussions (FGDs)/ethnography); mixed-methods; Implementation/program reports; Theses/dissertations with sufficient methods/results. Editorials, opinion pieces, narrative commentaries without empirical data; single-patient case reports not addressing psychosocial determinants; conference abstracts without sufficient data and no linked full report. Figure 2. PRISMA for Scoping Reviews (PRISMA-ScR) flowchart for study selection for the study titled Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol. Source: Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med, 2018,169 (7), 467–473. Eligibility criteria Stage 4: Data charting process A standardized data charting form will be developed and pilot-tested to ensure clarity, consistency, and suitability for capturing relevant information across studies. The form will be designed to capture essential information as outlined in Table 4 . Table 4. Data charting form. 1 Author(s) 2 Year of publication 3 Title of study 4 Aim of study 5 Study design 6 Study setting/country 7 Study population 8 Age group 9 Intervention characteristics – (stigma, depression, anxiety, social/family support, poverty, food insecurity, substance use, self-efficacy, health beliefs, gender norms) 10 Study outcomes (Reported outcomes: LTFU rates, retention rates, treatment interruption data) 11 Key findings 12 Recommendations from the study Stage 5: Data assessment, summarizing, and presenting the results A descriptive assessment to assess completeness of reporting; variability in LTFU definitions; presence/quality of measurement tools for psychosocial constructs will be performed. Both quantitative and qualitative methods will be utilized in the evaluation of scoping review results. Qualitative analysis will involve using themes to evaluate the data extraction table and develop overarching themes from the literature using tables and graphs that can assist in addressing the research questions and developing future research questions and frameworks emerging from psychosocial determinants of LTFU among DR-TB patients. The extracted data will be systematically organized into a table for easy comparison and analysis, categorizing information by study characteristics, psychosocial determinants of LTFU, health outcomes, adaptation strategies, and study quality. Secondly, quantitatively, a numerical summary using descriptive statistics will be conducted to explore opportunities for future studies across disciplines that may be under-represented in the publications reviewed. Quality assessment of included studies Quality assessment is not a core component of this scoping review, however, the study designs of included articles, qualitative, quantitative, and mixed methods will be documented to enhance transparency and consistency in reporting. This descriptive approach will aid in contextualizing the strength of the evidence base and in highlighting methodological gaps. No formal risk of bias assessment will be conducted as obtained in standard scoping review methodology. Stage 6: Consultation Stakeholders will not be involved in the design of this scoping review however, consultation with relevant actors including researchers, policymakers, and practitioners will be undertaken to validate the findings and support their interpretation for evidence-informed decision-making and practical application. Discussion By applying a PICOT-aligned approach, comprehensive multi-database and grey literature searches, dual-reviewer screening, and a piloted data-charting framework, the scoping review will map existing evidence and clarify how individual, interpersonal, community, and system/structural factors including stigma, mental health, substance use, social support, poverty, food insecurity, and distance/transport costs shape both pretreatment and on-treatment disengagement from care. The synthesis, reported in line with PRISMA-ScR, will prioritize transparency in definitions (especially heterogeneous LTFU thresholds), measurement tools for psychosocial constructs, and contextual modifiers such as HIV co-infection, regimen era (long vs. short all-oral), decentralization, and urban–rural setting. This review will inform National TB Program policies and frontline implementation, guide the design and target of patient-support packages and identify priorities for future research. The scope intentionally emphasizes breadth over causal inference and will not conduct meta-analysis; the review will document methodological limitations and reporting gaps to enable subsequent focused systematic reviews or primary studies. Through an optional stakeholder consultation with program managers, clinicians, community health workers, and patient representatives, the findings will be grounded in operational realities and ready for uptake. A limitation of this review is that the studies are limited to South Africa, given the high TB prevalence and incidence rates and it remains one of the global high-burden countries for TB. Overall, this protocol positions the review to deliver actionable, context-specific intelligence that can reduce LTFU, improve DR-TB treatment success, and accelerate progress toward South Africa’s End TB targets. Ethics and dissemination Ethical approval is not required for this scoping review. The findings of this review will be disseminated through peer-reviewed publications and academic presentations at local, national and international conferences. Policymakers and stakeholders will also benefit from reports generated from this study. Stakeholder consultation including National Tuberculosis Program managers, DR-TB clinicians/nurses, community health workers (CHWs), and patient representatives across provinces in South Africa will be carried out to validate findings and refine recommendations. Data availability statement Underlying data Walter Sisulu University Figshare: [Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol] https://doi.org/10.25406/wsu.30295396.v1 . 13 The project contains no underlying data. The current study did not produce or analyze any datasets, as no primary data will be collected, and all sources will be from publicly available literature. Upon research completion, all pertinent data will be made public. There will be a scoping review, and the outcomes will be presented. All data generated or analyzed during the scoping review will be included in the published article and its supplementary materials. No primary data will be collected, and all sources will be from publicly available literature through the systematic search process. Detailed search strategies, data charting forms, and extracted datasets will be provided as supplementary files to ensure transparency and reproducibility. Extended data Walter Sisulu University Figshare: [Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol]. https://doi.org/10.25406/wsu.30295396.v1 . 13 This project contains the following extended data: • Supplementary Checklist. (PRISMA-P checklist) • Supplementary Figure 1. (Six stages of conducting a scoping review) • Supplementary Figure 2. (PRISMA ScR flowchart) Reporting guidelines Figshare: PRISMA ScR checklist for ‘[Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review]’ https://doi.org/10.25406/wsu.30295396.v1 . 13 Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). Acknowledgment The authors are grateful to the librarian at the medical library of Walter Sisulu University for assisting in optimizing the search plan. References 1. World Health Organization Global tuberculosis report 2024. Geneva: WHO; 2023. Health Organization; 2023. (Accessed 18 August 2025). Reference Source 2. Seloma NM, Makgatho ME, Maimela E: Evaluation of drug-resistant tuberculosis treatment outcome in Limpopo province, South Africa. African Journal of Primary Health Care & Family Medicine. 2023; 15 (1): 3764. Publisher Full Text 3. Zhang SX, Miao FY, Yang J, et al. : Global, regional, and National burden of HIV-negative tuberculosis, 1990–2021: findings from the global burden of disease study 2021. Infect. Dis. Poverty. 2024; 13 (1): 60. Publisher Full Text 4. Liyew AM, Gebreyohannes EA, Python A, et al. : Mapping tuberculosis prevalence in Africa using a Bayesian geospatial analysis. Commun. Med. 2025; 5 (1): 194. Publisher Full Text 5. Tanue EA, Nsagha DS, Njamen TN, et al. : Tuberculosis treatment outcome and its associated factors among people living with HIV and AIDS in Fako Division of Cameroon. PloS one. 2019; 14 (7): e0218800. Publisher Full Text 6. World Health Organization Global tuberculosis report 2023. Geneva: WHO; 2023. Health Organization; 2023. (Accessed 18 August 2025). Reference Source 7. WHO consolidated guidelines on tuberculosis. Module 4: treatment - drug-resistant tuberculosis treatment, 2022 update. (Accessed 08 September 2025). Reference Source 8. Liyew AM, Clements AC, Wagnew F, et al. : Geospatial mapping of drug-resistant tuberculosis prevalence in Africa at national and sub-national levels. Int. J. Infect. Dis. 2025; 153 : 107777. Publisher Full Text 9. World Health Organization: Tackling the drug-resistant TB crisis. (Accessed 09 September 2025). Reference Source 10. Peters MDJ, Marnie C, Colquhoun H, et al. : Scoping reviews: Reinforcing and advancing the methodology and application. Syst. Rev. 2021; 10 : 263. Publisher Full Text 11. Peters MDJ, Godfrey C, McInerney P, et al. : Best practice guidance and reporting items for the development of scoping review protocols. JBI Evid. Synth. 2022; 20 : 953–968. Publisher Full Text 12. Tricco AC, Lillie E, Zarin W, et al. : PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann. Intern. Med. 2018; 169 : 467–473. Publisher Full Text 13. Hosu MC, Akapo OO, Ogbodu OM: Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol. [Dataset]. Figshare. 2025. Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 24 Dec 2025 ADD YOUR COMMENT Comment Author details Author details 1 Laboratory Medicine and Pathology, Walter Sisulu University Faculty of Health Sciences, Mthatha, Eastern Cape, 5100, South Africa 2 Laboratory Medicine and Pathology, Walter Sisulu University Faculty of Health Sciences, Mthatha, Eastern Cape, 5100, South Africa 3 Anaesthesiology and Critical Care, Walter Sisulu University Faculty of Health Sciences, Mthatha, Eastern Cape, 5100, South Africa Mojisola Clara Hosu Roles: Conceptualization, Data Curation, Investigation, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Olufunmilayo Olukemi Akapo Roles: Data Curation, Methodology, Validation, Writing – Review & Editing Olubunmi Margaret Ogbodu Roles: Data Curation, Methodology, Supervision, Validation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 24 Dec 2025, 14:1440 https://doi.org/10.12688/f1000research.171890.1 Copyright © 2025 Hosu MC et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Hosu MC, Akapo OO and Ogbodu OM. Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol [version 1; peer review: 2 not approved] . F1000Research 2025, 14 :1440 ( https://doi.org/10.12688/f1000research.171890.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 24 Dec 2025 Views 0 Cite How to cite this report: de Faria MGBF. Reviewer Report For: Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol [version 1; peer review: 2 not approved] . F1000Research 2025, 14 :1440 ( https://doi.org/10.5256/f1000research.189552.r460579 ) The direct URL for this report is: https://f1000research.com/articles/14-1440/v1#referee-response-460579 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 12 Mar 2026 Mariana Gaspar Botelho Funari de Faria , University of Sao Paulo, Ribeirao Preto, Brazil Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.189552.r460579 Manuscript Review This report refers to the analysis of the scoping review titled “Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol,” which aims to map and synthesize the evidence ... Continue reading READ ALL Manuscript Review This report refers to the analysis of the scoping review titled “Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol,” which aims to map and synthesize the evidence available in the literature regarding the proposed theme, using the Joanna Briggs Institute methodological framework through high sensitivity. The study presents scientific importance by addressing a theme of high relevance to public health; however, important points that compromise its reproducibility need to be revised. Qualitative Analysis of the Manuscript Title: Adequate Abstract: OK Keywords: None Introduction It is observed that the authors present consolidated data regarding the number of tuberculosis deaths in 2023. However, a predictive estimate for the same year is also presented subsequently. Considering that epidemiological bulletins with consolidated data for this period have already been published, the inclusion of estimates becomes redundant. It is recommended to revise this information and verify the adequacy of the bibliographic reference used. Although the introduction presents the general epidemiology of tuberculosis, specific data regarding drug-resistant tuberculosis (DR-TB) are not described. It is suggested to include epidemiological information regarding this condition to highlight the magnitude and relevance of the problem within the investigated context. Additionally, drug resistance does not result exclusively from the inadequate use of therapeutic regimens. Other factors, such as reinfection, loss to follow-up, and programmatic failures in disease management, also contribute to the emergence of DR-TB. It is recommended to revise this passage to account for the complexity of the determinants involved. For the conduct of a scoping review, it is essential that the authors present evidence from a preliminary literature search to demonstrate the existence of knowledge gaps that justify the original nature of the investigation. It is suggested to make this gap more explicit in the introduction. After the first definition of an acronym, it is not necessary to repeat its full form throughout the text. Thus, it is recommended to standardize the use of the acronym DR-TB after its first occurrence. The meaning attributed by the authors to the term “pre-treatment period” is also unclear. It is suggested to conceptually clarify this period to avoid interpretative ambiguities. In the sentence where the authors state that “psychosocial barriers to care remain inadequately addressed,” it is important to specify what these barriers are and how they have been neglected in the literature. Such detailing will contribute to clarifying the knowledge gap that underlies the research question. Furthermore, throughout the introduction, statements such as “evidence remains fragmented,” “inconsistently measured,” and “barriers remain inadequately addressed” are used. Such statements are critical in nature and, therefore, must be supported by previously published references or reviews that substantiate these findings. Methodology Study Design Step 6 presented by the authors does not correspond to the methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). This step actually refers to the sections on synthesis of evidence, limitations, and conclusions. It is recommended to revise the methodological organization to maintain adherence to the methodological frameworks of scoping reviews. Stage 1 – Defining the Research Question The three research questions presented seem to address related aspects, but in a fragmented way. It is recommended to reformulate a more comprehensive research question that encompasses the constituent elements of the three hypotheses raised. Additionally, the PICOT (or PIOT) strategy assumes the presence of an intervention, which does not apply adequately to the design of scoping reviews. For this type of review, it is recommended to use the PCC (Population, Concept, and Context) strategy, according to the methodological guidelines of the Joanna Briggs Institute. Stage 2 – Developing the Search Strategy The search strategy described for the databases must be applied equivalently to grey literature sources. If a preliminary search had been conducted and described in the introduction, the authors would likely have greater clarity regarding the scope of evidence available in the literature, which would contribute to the refinement of the search strategy. Quality Assessment of Included Studies Although methodological quality assessment is not mandatory in scoping reviews, performing it can add robustness to the analysis of the included evidence. In this sense, it is recommended to consider the use of specific instruments for methodological quality assessment, including tools aimed at mixed-methods studies. Discussion Meta-analysis is an analytical technique typical of systematic reviews with quantitative synthesis of results using only one methodology. In scoping reviews, the central objective consists of mapping the existing literature, identifying knowledge gaps, and characterizing the nature of the available evidence, especially in broad or emerging fields of investigation. Therefore, it is recommended to revise this section to align the discussion with the objectives and methodological assumptions of a scoping review, as it is not restricted to documenting methodological limitations and reporting gaps to allow for focused systematic reviews or subsequent primary studies. Overall, the manuscript addresses a relevant theme in the field of drug-resistant tuberculosis control. However, after a detailed analysis of the text, substantial conceptual and methodological limitations are observed that compromise the study's scientific consistency. In particular, inconsistencies are identified in the theoretical foundation of the introduction, an absence of a clear delimitation of the knowledge gap that would justify conducting the review, and inadequacies in the methodological conduct of the scoping review. Among other aspects, the inappropriate use of the PICOT strategy stands out, as it is more suitable for systematic reviews focused on interventions, to the detriment of the PCC strategy recommended for scoping reviews. Additionally, there are inconsistencies in the description of the methodological steps regarding the PRISMA-ScR and Joanna Briggs Institute frameworks, as well as limitations in the search strategy and the delimitation of the research question. Considering the set of these limitations, it is understood that the manuscript, in its current form, presents structural and methodological weaknesses that hinder its alignment with the scientific standards expected for indexing. Therefore, it is recommended that the manuscript not be accepted for indexing at this time. Is the rationale for, and objectives of, the study clearly described? Partly Is the study design appropriate for the research question? Partly Are sufficient details of the methods provided to allow replication by others? Partly Are the datasets clearly presented in a useable and accessible format? Yes Competing Interests: No competing interests were disclosed. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT de Faria MGBF. Reviewer Report For: Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol [version 1; peer review: 2 not approved] . F1000Research 2025, 14 :1440 ( https://doi.org/10.5256/f1000research.189552.r460579 ) The direct URL for this report is: https://f1000research.com/articles/14-1440/v1#referee-response-460579 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Hoddinott G. Reviewer Report For: Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol [version 1; peer review: 2 not approved] . F1000Research 2025, 14 :1440 ( https://doi.org/10.5256/f1000research.189552.r448032 ) The direct URL for this report is: https://f1000research.com/articles/14-1440/v1#referee-response-448032 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 08 Jan 2026 Graeme Hoddinott , The University of Sydney, Sydney, New South Wales, Australia; Department of Paediatrics and Child Health, Stellenbosch UniversityTown, Cape, Western Cape, South Africa Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.189552.r448032 Dear authors - This is an important piece of work to do. I agree completely that the evidence is fragmented. A laudable plan. I suggest that your protocol can be strengthened by introducing more of a summary of what ... Continue reading READ ALL Dear authors - This is an important piece of work to do. I agree completely that the evidence is fragmented. A laudable plan. I suggest that your protocol can be strengthened by introducing more of a summary of what HAS been written about the importance of psychosocial determinants. Even if these come from DS-TB. I'm not meaning that you must do the scoping review before doing the scoping review. But just a few key papers to establish that this area has been identified as important. Specific comments: 1. There is a new Global TB report out, please update the first paragraph and citation accordingly. Final sentence of the first paragraph - is this TB infections or TB disease notifications? The vast majority of people who breathe in a TB bug (i.e., are 'infected') never progress to disease and are therefore incidence is not monitored epidemiologically. 2. Second sentence of the second paragraph - please note that most incident DR-TB is transmitted, NOT acquired. And the term 'misuse' might be construed as judgemental toward patients. Suggest that this be revised. 3. No citation provided here: "DR-TB infected patients face significant economic and social costs and only 33% access quality care". Where does the 33% come from? No citations here, and summarising what is already known about psychosocial determinants is essential, it requires a thorough summation of this evidence with multiple citations: "Psychosocial determinants including stigma, depression, poverty, social isolation, and lack of family support are increasingly recognized as critical factors influencing LTFU. While several studies have explored these factors in various contexts, the evidence remains fragmented and scattered, necessitating a comprehensive mapping through a scoping review." Include citation: "Given South Africa’s National TB Program’s call for patient-centered, evidence-based strategies". In stage 3, will you also look through the reference lists of papers that you end up including in the full-text review? Stage 6 - what exactly will the consultation look like? Sending them an email with a draft report and an invitation to comment? A meeting to discuss? Is the rationale for, and objectives of, the study clearly described? Partly Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Partly Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests: No competing interests were disclosed. Reviewer Expertise: Socio-behavioural science; Tuberculosis I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Hoddinott G. Reviewer Report For: Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol [version 1; peer review: 2 not approved] . F1000Research 2025, 14 :1440 ( https://doi.org/10.5256/f1000research.189552.r448032 ) The direct URL for this report is: https://f1000research.com/articles/14-1440/v1#referee-response-448032 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 24 Dec 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 Version 1 24 Dec 25 read read Graeme Hoddinott , The University of Sydney, Sydney, Australia; Stellenbosch UniversityTown, Cape, South Africa Mariana Gaspar Botelho Funari de Faria , University of Sao Paulo, Ribeirao Preto, Brazil Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 de Faria M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 12 Mar 2026 | for Version 1 Mariana Gaspar Botelho Funari de Faria , University of Sao Paulo, Ribeirao Preto, Brazil 0 Views copyright © 2026 de Faria M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Manuscript Review This report refers to the analysis of the scoping review titled “Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol,” which aims to map and synthesize the evidence available in the literature regarding the proposed theme, using the Joanna Briggs Institute methodological framework through high sensitivity. The study presents scientific importance by addressing a theme of high relevance to public health; however, important points that compromise its reproducibility need to be revised. Qualitative Analysis of the Manuscript Title: Adequate Abstract: OK Keywords: None Introduction It is observed that the authors present consolidated data regarding the number of tuberculosis deaths in 2023. However, a predictive estimate for the same year is also presented subsequently. Considering that epidemiological bulletins with consolidated data for this period have already been published, the inclusion of estimates becomes redundant. It is recommended to revise this information and verify the adequacy of the bibliographic reference used. Although the introduction presents the general epidemiology of tuberculosis, specific data regarding drug-resistant tuberculosis (DR-TB) are not described. It is suggested to include epidemiological information regarding this condition to highlight the magnitude and relevance of the problem within the investigated context. Additionally, drug resistance does not result exclusively from the inadequate use of therapeutic regimens. Other factors, such as reinfection, loss to follow-up, and programmatic failures in disease management, also contribute to the emergence of DR-TB. It is recommended to revise this passage to account for the complexity of the determinants involved. For the conduct of a scoping review, it is essential that the authors present evidence from a preliminary literature search to demonstrate the existence of knowledge gaps that justify the original nature of the investigation. It is suggested to make this gap more explicit in the introduction. After the first definition of an acronym, it is not necessary to repeat its full form throughout the text. Thus, it is recommended to standardize the use of the acronym DR-TB after its first occurrence. The meaning attributed by the authors to the term “pre-treatment period” is also unclear. It is suggested to conceptually clarify this period to avoid interpretative ambiguities. In the sentence where the authors state that “psychosocial barriers to care remain inadequately addressed,” it is important to specify what these barriers are and how they have been neglected in the literature. Such detailing will contribute to clarifying the knowledge gap that underlies the research question. Furthermore, throughout the introduction, statements such as “evidence remains fragmented,” “inconsistently measured,” and “barriers remain inadequately addressed” are used. Such statements are critical in nature and, therefore, must be supported by previously published references or reviews that substantiate these findings. Methodology Study Design Step 6 presented by the authors does not correspond to the methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). This step actually refers to the sections on synthesis of evidence, limitations, and conclusions. It is recommended to revise the methodological organization to maintain adherence to the methodological frameworks of scoping reviews. Stage 1 – Defining the Research Question The three research questions presented seem to address related aspects, but in a fragmented way. It is recommended to reformulate a more comprehensive research question that encompasses the constituent elements of the three hypotheses raised. Additionally, the PICOT (or PIOT) strategy assumes the presence of an intervention, which does not apply adequately to the design of scoping reviews. For this type of review, it is recommended to use the PCC (Population, Concept, and Context) strategy, according to the methodological guidelines of the Joanna Briggs Institute. Stage 2 – Developing the Search Strategy The search strategy described for the databases must be applied equivalently to grey literature sources. If a preliminary search had been conducted and described in the introduction, the authors would likely have greater clarity regarding the scope of evidence available in the literature, which would contribute to the refinement of the search strategy. Quality Assessment of Included Studies Although methodological quality assessment is not mandatory in scoping reviews, performing it can add robustness to the analysis of the included evidence. In this sense, it is recommended to consider the use of specific instruments for methodological quality assessment, including tools aimed at mixed-methods studies. Discussion Meta-analysis is an analytical technique typical of systematic reviews with quantitative synthesis of results using only one methodology. In scoping reviews, the central objective consists of mapping the existing literature, identifying knowledge gaps, and characterizing the nature of the available evidence, especially in broad or emerging fields of investigation. Therefore, it is recommended to revise this section to align the discussion with the objectives and methodological assumptions of a scoping review, as it is not restricted to documenting methodological limitations and reporting gaps to allow for focused systematic reviews or subsequent primary studies. Overall, the manuscript addresses a relevant theme in the field of drug-resistant tuberculosis control. However, after a detailed analysis of the text, substantial conceptual and methodological limitations are observed that compromise the study's scientific consistency. In particular, inconsistencies are identified in the theoretical foundation of the introduction, an absence of a clear delimitation of the knowledge gap that would justify conducting the review, and inadequacies in the methodological conduct of the scoping review. Among other aspects, the inappropriate use of the PICOT strategy stands out, as it is more suitable for systematic reviews focused on interventions, to the detriment of the PCC strategy recommended for scoping reviews. Additionally, there are inconsistencies in the description of the methodological steps regarding the PRISMA-ScR and Joanna Briggs Institute frameworks, as well as limitations in the search strategy and the delimitation of the research question. Considering the set of these limitations, it is understood that the manuscript, in its current form, presents structural and methodological weaknesses that hinder its alignment with the scientific standards expected for indexing. Therefore, it is recommended that the manuscript not be accepted for indexing at this time. Is the rationale for, and objectives of, the study clearly described? Partly Is the study design appropriate for the research question? Partly Are sufficient details of the methods provided to allow replication by others? Partly Are the datasets clearly presented in a useable and accessible format? Yes Competing Interests No competing interests were disclosed. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) de Faria MGBF. Peer Review Report For: Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol [version 1; peer review: 2 not approved] . F1000Research 2025, 14 :1440 ( https://doi.org/10.5256/f1000research.189552.r460579) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-1440/v1#referee-response-460579 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 Hoddinott G. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 08 Jan 2026 | for Version 1 Graeme Hoddinott , The University of Sydney, Sydney, New South Wales, Australia; Department of Paediatrics and Child Health, Stellenbosch UniversityTown, Cape, Western Cape, South Africa 0 Views copyright © 2026 Hoddinott G. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Dear authors - This is an important piece of work to do. I agree completely that the evidence is fragmented. A laudable plan. I suggest that your protocol can be strengthened by introducing more of a summary of what HAS been written about the importance of psychosocial determinants. Even if these come from DS-TB. I'm not meaning that you must do the scoping review before doing the scoping review. But just a few key papers to establish that this area has been identified as important. Specific comments: 1. There is a new Global TB report out, please update the first paragraph and citation accordingly. Final sentence of the first paragraph - is this TB infections or TB disease notifications? The vast majority of people who breathe in a TB bug (i.e., are 'infected') never progress to disease and are therefore incidence is not monitored epidemiologically. 2. Second sentence of the second paragraph - please note that most incident DR-TB is transmitted, NOT acquired. And the term 'misuse' might be construed as judgemental toward patients. Suggest that this be revised. 3. No citation provided here: "DR-TB infected patients face significant economic and social costs and only 33% access quality care". Where does the 33% come from? No citations here, and summarising what is already known about psychosocial determinants is essential, it requires a thorough summation of this evidence with multiple citations: "Psychosocial determinants including stigma, depression, poverty, social isolation, and lack of family support are increasingly recognized as critical factors influencing LTFU. While several studies have explored these factors in various contexts, the evidence remains fragmented and scattered, necessitating a comprehensive mapping through a scoping review." Include citation: "Given South Africa’s National TB Program’s call for patient-centered, evidence-based strategies". In stage 3, will you also look through the reference lists of papers that you end up including in the full-text review? Stage 6 - what exactly will the consultation look like? Sending them an email with a draft report and an invitation to comment? A meeting to discuss? Is the rationale for, and objectives of, the study clearly described? Partly Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Partly Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests No competing interests were disclosed. Reviewer Expertise Socio-behavioural science; Tuberculosis I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Hoddinott G. Peer Review Report For: Mapping Psychosocial Determinants of Loss to Follow-Up Among Drug-resistant Tuberculosis Patients in South Africa: A Scoping Review Protocol [version 1; peer review: 2 not approved] . F1000Research 2025, 14 :1440 ( https://doi.org/10.5256/f1000research.189552.r448032) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-1440/v1#referee-response-448032 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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