Patients direct costs to undergo TB diagnosis

Anderson de Cuevas, Rachel M ORCID: 0000-0001-7790-5332, Lawson, Lovett, Al-Sonboli, Najla, Al-Aghbari, Nasher, Arbide, Isabel, Sherchand, Jeevan B, Nnamdi, Emenyonu E, Aseffa, Abraham, Yassin, Mohammed A, Abdurrahman, Saddiq T
et al (show 7 more authors) (2016) Patients direct costs to undergo TB diagnosis. INFECTIOUS DISEASES OF POVERTY, 5 (1). 24-.

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<h4>Background</h4>A major impediment to the treatment of TB is a diagnostic process that requires multiple visits. Descriptions of patient costs associated with diagnosis use different protocols and are not comparable.<h4>Methods</h4>We aimed to describe the direct costs incurred by adults attending TB diagnostic centres in four countries and factors associated with expenditure for diagnosis. Surveys of 2225 adults attending smear-microscopy centres in Nigeria, Nepal, Ethiopia and Yemen. Adults >18 years with cough >2 weeks were enrolled prospectively. Direct costs were quantified using structured questionnaires. Patients with costs >75(th) quartile were considered to have high expenditure (cases) and compared with patients with costs <75(th) quartile to identify factors associated with high expenditure.<h4>Results</h4>The most significant expenses were due to clinic fees and transport. Most participants attended the centres with companions. High expenditure was associated with attending with company, residing in rural areas/other towns and illiteracy.<h4>Conclusions</h4>The costs incurred by patients are substantial and share common patterns across countries. Removing user fees, transparent charging policies and reimbursing clinic expenses would reduce the poverty-inducing effects of direct diagnostic costs. In locations with limited resources, support could be prioritised for those most at risk of high expenditure; those who are illiterate, attend the service with company and rural residents.

Item Type: Article
Uncontrolled Keywords: Tuberculosis, Costs, Access to healthcare, Ethiopia, Nepal, Nigeria, Yemen
Depositing User: Symplectic Admin
Date Deposited: 31 May 2016 08:12
Last Modified: 19 Jan 2023 07:36
DOI: 10.1186/s40249-016-0117-x
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