Walcott, Rebecca L.Ingels, Justin B.Corso, Phaedra S.Zalwango, SarahWhalen, Christopher C.Sekandi, Juliet N.2022-06-072022-06-072020Rebecca 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: 10.1080/17441692.2020.1724313https://doi.org/10.1080/17441692.2020.1724313https://nru.uncst.go.ug/handle/123456789/3801Identifying 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.enCatastrophic costsCost analysisDissavingTuberculosis (TB)UgandaArticle