There’s no such thing as a free TB diagnosis: Catastrophic TB costs in Urban Uganda
Loading...
Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Global Public Health
Abstract
Identifying and reducing TB-related costs is necessary for achieving the
End TB Strategy’s goal that no family is burdened with catastrophic
costs. This study explores costs during the pre-diagnosis period and
assesses the potential for using coping costs as a proxy indicator for
catastrophic costs when comprehensive surveys are not feasible.
Detailed interviews about TB-related costs and productivity losses were
conducted with 196 pulmonary TB patients in Kampala, Uganda. The
threshold for catastrophic costs was defined as 20% of household
income. Multivariable regression analyses were used to assess the
influence of patient characteristics on economic burden, and the
positive predictive value (PPV) of coping costs was estimated. Over 40%
of patients experienced catastrophic costs, with average (median) prediagnosis
costs making up 30.6% (14.1%) of household income. Lowincome
status (AOR = 2.91, 95% CI = 1.29, 6.72), hospitalisation (AOR =
8.66, 95% CI = 2.60; 39.54), and coping costs (AOR = 3.84, 95% CI = 1.81;
8.40) were significantly associated with the experience of catastrophic
costs. The PPV of coping costs as an indicator for catastrophic costs was
estimated to be 73% (95% CI = 58%, 84%). TB patients endure a
substantial economic burden during the pre-diagnosis period, and
identifying households that experience coping costs may be a useful
proxy measure for identifying catastrophic costs.
Description
Keywords
Catastrophic costs, Cost analysis, Dissaving, Tuberculosis (TB), Uganda
Citation
Rebecca L. Walcott, Justin B. Ingels, Phaedra S. Corso, Sarah Zalwango, Christopher C. Whalen & Juliet N. Sekandi (2020): There’s no such thing as a free TB diagnosis: Catastrophic TB costs in Urban Uganda, Global Public Health, DOI: 10.1080/17441692.2020.1724313