TY - JOUR AU - Cuevas RA AU - Lawson L AU - Al-Sonboli N AU - Al-Aghbari N AU - Arbide I AU - Sherchand J AU - Nnamdi EE AU - Aseffa A AU - Yassin MA AU - Abdurrahman ST AU - Obasanya J AU - Olanrewaju O AU - Datiko D AU - Theobald S AU - Ramsay A AU - Squire BS AU - Cuevas L AB -

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.

BT - Infectious diseases of poverty C1 -

http://www.ncbi.nlm.nih.gov/pubmed/27009093?dopt=Abstract

DO - 10.1186/s40249-016-0117-x IS - 1 J2 - Infect Dis Poverty LA - eng N2 -

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.

PY - 2016 EP - 24 T2 - Infectious diseases of poverty TI - Patients direct costs to undergo TB diagnosis. UR - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4806474/pdf/40249_2016_Article_117.pdf VL - 5 SN - 2049-9957 ER -