Bibliographic Details
| Title: |
There's no such thing as a free TB diagnosis: Catastrophic TB costs in Urban Uganda. |
| Authors: |
Walcott, Rebecca L.1 walcott@uw.edu, Ingels, Justin B.2, Corso, Phaedra S.3, Zalwango, Sarah4, Whalen, Christopher C.5, Sekandi, Juliet N.5 |
| Source: |
Global Public Health. Jun2020, Vol. 15 Issue 6, p877-888. 12p. |
| Subject Terms: |
*PSYCHOLOGICAL adaptation, *CONFIDENCE intervals, *ECONOMIC aspects of diseases, *HELP-seeking behavior, *HIV infections, *HOSPITAL care, *INTERVIEWING, *LABOR productivity, *MEDICAL care costs, *METROPOLITAN areas, *RESEARCH funding, *SEX distribution, *TUBERCULOSIS, *COST analysis, *NET losses, *ECONOMIC status, *MULTIPLE regression analysis, *RETROSPECTIVE studies, *DATA analysis software, *DESCRIPTIVE statistics, *ODDS ratio |
| Geographic Terms: |
UGANDA |
| 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) pre-diagnosis costs making up 30.6% (14.1%) of household income. Low-income 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. [ABSTRACT FROM AUTHOR] |
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