Custos catastróficos e sequelas sociais decorrentes do diagnóstico e tratamento da tuberculose no Brasil

Guidoni, Laura; Zandonade, Eliana; Fregona, Geisa; Negri, Leticya dos Santos Almeida; Oliveira, Sandra Maria do Valle Leone de; Prado, Thiago Nascimento do; Sales, Carolina Maia Martins; Coimbra, Raisa da Silveira; Galavote, Heletícia Scabelo; Maciel, Ethel Leonor Nóia

doi:10.1590/s1679-49742021000300012

Cited by 6 publications

(2 citation statements)

References 13 publications

(29 reference statements)

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“…Indeed, we found that in Peruvian shantytowns when costs due to TB exceeded 20% of the pre-illness income of that household, then treatment outcomes were more likely to be adverse (treatment non-completion, treatment failure or death during treatment) than favourable (cure or treatment completion) 3 . Similar findings have been reported in Brazil and Moldova 4 , 5 . Consequently, costs due to TB are usually considered to be catastrophic if they exceed a threshold of 20% of the pre-illness household annual income 6 , although other thresholds have been used occasionally 7 , 8 .…”

Section: Introductionsupporting

confidence: 91%

Interventions aiming to eliminate catastrophic costs due to tuberculosis: a protocol for a systematic review and meta-analysis

Carballo-Jimenez¹,

Datta²,

Aguirre-Ipenza³

et al. 2022

Wellcome Open Res

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Background: People with tuberculosis disease and their household members may suffer direct out-of-pocket expenses and indirect costs of lost income. These tuberculosis-related costs can worsen poverty, make tuberculosis treatment completion unaffordable, impair quality of life and increase the risk of death. Costs due to tuberculosis are usually defined as catastrophic if they exceed 20% of the pre-disease annual household income. The World Health Organisation strategy to “End TB” and the United Nations Sustainable Development Goals include the target that no households should face catastrophic costs due to tuberculosis. However, there is limited evidence and policy concerning how this global priority of eliminating catastrophic costs due to tuberculosis should be achieved. This systematic review and meta-analysis aims to address this knowledge gap. Methods: Publications assessing interventions that aimed to eliminate catastrophic costs will be identified by searching three electronic databases (PubMed, Scopus and Web of Science) together with reference lists from pertinent publications. We will screen eligible studies, extract data, and assess the risk of bias with the quality assessment tool from the National Heart, Lung, and Blood Institute. Discrepancies will be resolved by discussion between the reviewers. If we find sufficient comparable studies quantifying strategies to eliminate catastrophic costs then a meta-analysis will be performed. This systematic review and meta-analysis is registered with the PROSPERO database (CRD42022292410). Conclusion: This systematic review and meta-analysis aims to rigorously assess the evidence for strategies to eliminate catastrophic costs due to tuberculosis.

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Section: Introductionsupporting

confidence: 91%

Interventions aiming to eliminate catastrophic costs due to tuberculosis: a protocol for a systematic review and meta-analysis

Carballo-Jimenez¹,

Datta²,

Aguirre-Ipenza³

et al. 2022

Wellcome Open Res

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“…• número de cômodos no domicílio (00; até 01 cômodo; de 01 a 02; de 02 a 03; de 03 a 10; > 10 cômodos); 11 , a TB tem sido estigmatizada à desigualdade social 12 , acometendo com maior frequência em pacientes de baixo nível social 13 . Isso pode ser observado, principalmente, nos custos elevadíssimos que os pacientes e seus familiares estão sujeitos durante o episódio de TB 13 , pois desde a procura pelo diagnóstico até a realização e conclusão do tratamento, os pacientes enfrentam perdas financeiras importantes e programas de proteção social com transferência de renda podem ser importantes mecanismos de enfrentamento desses fardos econômicos vivenciados pelos pacientes [14][15] .…”

Section: Introductionunclassified

Fatores sociais preditores de cura da tuberculose em capitais brasileiras

Ferreira

Mascarello²,

Cola³

et al. 2022

RBPS

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Introdução: O impacto econômico da Tuberculose (TB) leva ao empobrecimento das famílias em países de baixa e média renda, mesmo o tratamento sendo ofertado sem custos. Um dos objetivos da Organização Mundial de Saúde é que nenhum domicílio afetado pela TB sofra com custos catastróficos da doença. Objetivos: O presente estudo teve como objetivo avaliar quais os determinantes sociais estão relacionados com a incidência de casos de Tuberculose em relação ao seu desfecho compilando dados de sete capitais brasileiras (Fortaleza ‒ CE, Manaus ‒ AM, Porto Alegre ‒ RS, Recife ‒ RN, Salvador ‒ BA, São Paulo ‒ SP e Vitória ‒ ES). Métodos: Estudo transversal. Foram calculadas medidas de associação entre Determinantes Sociais e o desfecho de cura para TB através de análises bi e multivariadas e regressão logística para estimar razões de chance (Odds Ratio). Resultados e Discussão: Dos 1.149 participantes, 79.37% tiveram desfecho favorável (cura) e 31.8% desfavorável (óbito/abandono do tratamento), que se associaram significativamente aos determinantes: idade, estado civil, ocupação, plano de saúde, renda familiar, número de quartos e educação. Conclusão: As maiores chances de cura aos pacientes com TB estão associadas às melhores condições socioeconômicas e o baixo nível social é uma barreira importante para o sucesso do tratamento de TB.

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Assessing the influencing factors of out-of-pocket costs on tuberculosis in Sichuan Province: a cross-sectional study

et al. 2023

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Background Although diagnosis and treatment services for tuberculosis (TB) are provided free of charge in most countries, direct non-medical and indirect costs due to absenteeism, also place a significant burden on patients and their families. Sichuan Province has the second highest incidence of TB in China, with an incidence of approximately 100 cases per 100 000 people. However, there are limited research on out-of-pocket expenditure (OOPE) and its influencing factors in TB patients in Sichuan Province. Methods A retrospective cross-sectional study was conducted on TB patients in designated medical institutions for TB in Sichuan Province from 2017-2021. A face-to-face questionnaire was conducted to obtain the information related to hospitalization of patients, and the multi-level regression model was used to analyse the factors that influence OOPE and total out-of-pocket expenditure (TOOPE) of TB patients. Results A total of 2644 patients were investigated, and 74.24% of TB patients and their families experienced catastrophic total costs due to TB. The median total cost was 9223.37 CNY (1429.98 USD), in which the median direct and indirect costs of TB patients were 10185.00 CNY (1579.07 USD) and 2400.00 CNY (372.09 USD), respectively, and indirect costs contributed to 43% of total costs. The median OOPE and TOOPE costs were 6024.00 CNY (933.95 USD) and 11890.50 CNY (1843.49 USD), respectively. OOPE and TOOPE had common influencing factors including whether the patient's family had four or more members, a history of hospitalization, combination with other types of TB, the number of visits before diagnosis, and co-occurrence with chronic disease. Conclusions The OOPE and TOOPE for TB patients and their families in Sichuan Province are still heavy. In the long run, it is necessary to strengthen education and awareness campaigns on TB related knowledge, disseminate basic medical knowledge to the public, improve healthcare-seeking behavior, and enhance the healthcare infrastructure to improve the accuracy of TB diagnosis and reduce the significant OOPE and TOOPE faced by TB patients and their families in Sichuan Province.

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Custos catastróficos e sequelas sociais decorrentes do diagnóstico e tratamento da tuberculose no Brasil

Cited by 6 publications

References 13 publications

Interventions aiming to eliminate catastrophic costs due to tuberculosis: a protocol for a systematic review and meta-analysis

Interventions aiming to eliminate catastrophic costs due to tuberculosis: a protocol for a systematic review and meta-analysis

Fatores sociais preditores de cura da tuberculose em capitais brasileiras

Assessing the influencing factors of out-of-pocket costs on tuberculosis in Sichuan Province: a cross-sectional study

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