Is Tuberculosis Treatment Truly Free? A Study to Identify Key Factors Contributing to the Catastrophic Cost of TB Care in Pakistan

Ikram, Aamer; Ali, Amna M.; Abbasi, Sana Habib; Ashraf, Nosheen; Wali, Sidra; Salman, Mohammad; Khan, Mumtaz Ali; Syed, Naveed Ahmed; Ansari, Jamil

doi:10.4236/jtr.2020.84017

Cited by 5 publications

(12 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Paper quality was very good in one study 38 and good in thirteen studies 6 , 18 , 19 , 31 – 34 , 36 , 37 , 41 , 42 , 44 , 45 . Fourteen studies were of satisfactory quality 14 – 17 , 20 , 35 , 39 , 40 , 43 , 45 – 48 , 50 and one was unsatisfactory 49 (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…The main predictors of catastrophic costs were food and nutritional supplements 37 – 39 , travel and transportation 35 , 36 , 50 , age category 31 , 36 , 44 , employment status 34 , 36 , 40 , 44 , 48 , the socioeconomic status 15 , 34 , 36 , 44 , 47 , 48 , 52 , MDR or HIV positive 31 , 36 , 39 , 52 , male gender 44 , 47 , 48 , and duration of hospitalization 15 , 31 , 36 , 48 , 50 .…”

Section: Primary Outcomementioning

confidence: 99%

See 1 more Smart Citation

A systematic review and meta-analysis of the catastrophic costs incurred by tuberculosis patients

Ghazy

Saeh

Abdelmoneim

et al. 2022

Sci Rep

View full text Add to dashboard Cite

One of the strategies of the World Health Organization End Tuberculosis (TB) was to reduce the catastrophic costs incurred by TB-affected families to 0% by 2020.Catastrophic cost is defined by the total cost related to TB management exceeding 20% of the annual pre-TB household income. This study aimed to estimate the pooled proportion of TB affected households who incurred catastrophic costs. We searched PubMed, SciELO, Scopus, Embase, Google Scholar, ProQuest, SAGE, and Web of Science databases according to Preferred Reporting Items of the Systematic Reviews and Meta-Analysis (PRISMA) guidelines till November 20, 2020. Eligible studies were identified and data on catastrophic costs due to TB were extracted. We performed a meta-analysis to generate the pooled proportion of patients with TB facing catastrophic costs. From 5114 studies identified, 29 articles were included in the final analysis. The pooled proportion of patients faced catastrophic costs was (43%, 95% CI [34–51]). Meta-regression revealed that country, drug sensitivity, and Human immune-deficiency Virus (HIV) co-infection were the main predictors of such costs. Catastrophic costs incurred by drug sensitive, drug resistant, and HIV co-infection were 32%, 81%, and 81%, respectively. The catastrophic costs incurred were lower among active than passive case findings (12% vs. 30%). Half (50%) of TB-affected households faced catastrophic health expenditure at 10% cut-off point. The financial burden of patients seeking TB diagnosis and treatment continues to be a worldwide impediment. Therefore, the End TB approach should rely on socioeconomic support and cost-cutting initiatives.PROSPERO registration: CRD42020221283.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Primary Outcomementioning

confidence: 99%

A systematic review and meta-analysis of the catastrophic costs incurred by tuberculosis patients

Ghazy

Saeh

Abdelmoneim

et al. 2022

Sci Rep

View full text Add to dashboard Cite

show abstract

“…The sample size ranged from 50 [29], to 1178 [30]. The tool used for estimation of the cost survey were either WHO TB cost survey tool, [5], [15], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39], [40] & [44], or adapted WHO tool to Indonesian context [12] & [41], or structured questionnaire [17], [26], [42], [43], pre-coded interview scheduled [18],or tool of stop TB partnership, [13], [27], [28],or headcount tool [44], or Lumley T. survey [14], or TB coalition tool [16]. On the other hand, there were two studies not mentioned the tool used [29], [45].…”

Section: Resultsmentioning

confidence: 99%

“…The Good score ranged from 7 to 8 pints, was among thirteen studies [5], [16], [17], [26], [28], [31], [32], [33], [37], [38], [39], [41] & [45]. While Satisfactory score which ranged from 5 to 6 points, was illustrated in the remaining fourteen studies, [12], [13], [14], [15], [18], [27], [30], [35], [36], [40], [42], [43], [44] & [45].…”

Section: Resultsmentioning

confidence: 99%

“…In this study, there are multiple main predictors of catastrophic cost like food and nutritional supplements [33–35],travel and transportation [30, 32, 45], age category [26, 28, 32], employment status [26, 32, 36, 41, 44], the socioeconomic status[13, 26, 27, 32, 41, 44, 47], MDR or HIV positive [28, 32, 35, 47], male gender, [26, 27, 44], and duration of hospitalization [13, 28, 32, 44, 45].…”

Section: Primary Outcomementioning

confidence: 99%

See 1 more Smart Citation

A Systematic Review and Meta-Analysis on Catastrophic Cost incurred by Tuberculosis Patients and their Households

Hme

S³

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: As one of the World Health Organization (WHO) End Tuberculosis (TB) Strategy is to reduce the proportion of TB affected families that face catastrophic costs to 0% by 2020. This systematic review and meta-analysis aimed to estimate the pooled proportion of TB affected households who face catastrophic cost. Method: A search of the online database through September 2020 was performed. A total of 5114 articles were found, of which 29 articles got included in quantitative synthesis. Catastrophic cost is defined if total cost related to TB exceeded 20% of annual pre-TB household income. R software was used to estimate the pooled proportion at 95% confidence intervals (CIs) using the fixed/random-effect models. Result: The proportion of patients faced catastrophic cost was 43% (95% CI 34-52, I2= 99%. 32% (95% CI 29 - 35, I2= 70%) among drug sensitive, and 80% (95% CI 74-85, I2=54%) among drug resistant, and 81% (95% CI 78-84%, I2= 0%) among HIV patients. Regarding active versus passive case finding the pooled proportion of catastrophic cost was 12% (95% CI 9-16, I2= 95%) versus 42% (95% CI 35-50, I2= 94%). The pooled proportion of direct cost to the total cost was 45% (95% CI 39-51, I2= 91%). The pooled proportion of patients facing catastrophic health expenditure (CHE) at cut of point of 10% of their yearly income was 45% (95% CI 35-56, I2= 93%) while at 40% of their capacity to pay was 63% (95% CI 40-80, I2= 96%). Conclusion: Despite the ongoing efforts, there is a significant proportion of patients facing catastrophic cost, which represent a main obstacle against TB control.

show abstract

Better understanding extrapulmonary tuberculosis: A scoping review of public health impact in Pakistan, Afghanistan, India, and Bangladesh

Jawed

Tharwani

Siddiqui

et al. 2023

Health Science Reports

View full text Add to dashboard Cite

Background and Aims: South Asian countries, including Pakistan, Afghanistan, India, and Bangladesh, have a high prevalence of pulmonary and extra-pulmonary tuberculosis (EPTB). This prevalence is influenced by various risk factors such as ethnicity, nutrition, socioeconomic disparities, high out-of-pocket healthcare expenses, and specific Mycobacterium Tuberculosis (TB) lineages. The COVID-19 pandemic has likely hindered access to healthcare and led to under-reporting of EPTB cases nationally and internationally. This rapid review aimed to summarize the literature on the prevalence and disease outcomes of EPTB in the mentioned countries, compare the situations across countries, and provide recommendations for future action. Methods: The review utilized PubMed and Google Scholar databases to search for literature on EPTB in South Asian countries. The search string included keywords related to different forms of EPTB and the countries of interest while excluding pulmonary tuberculosis. Results:The results showed that both TB, including drug-resistant TB, and EPTB are prevalent and burdensome in South Asia. In Pakistan, pleural TB was the most commonly reported form of EPTB, followed by lymph node TB, abdominal TB, osteoarticular TB, Central Nervous System TB, and miliary TB. In India, lymph node TB(LNTB) was more common among EPTB cases. Bangladesh reported a high prevalence of EPTB involving lymph node, pleura, and abdomen, while Afghanistan had a higher prevalence of forms such as LNTB and tuberculous meningitis. Conclusion:In conclusion, the prevalence of EPTB in Pakistan, Afghanistan, India, and Bangladesh is alarmingly high and negatively impacts population health.Effective measures are needed for treatment and management of this condition,

show abstract

Is Tuberculosis Treatment Truly Free? A Study to Identify Key Factors Contributing to the Catastrophic Cost of TB Care in Pakistan

Cited by 5 publications

References 24 publications

A systematic review and meta-analysis of the catastrophic costs incurred by tuberculosis patients

A systematic review and meta-analysis of the catastrophic costs incurred by tuberculosis patients

A Systematic Review and Meta-Analysis on Catastrophic Cost incurred by Tuberculosis Patients and their Households

Better understanding extrapulmonary tuberculosis: A scoping review of public health impact in Pakistan, Afghanistan, India, and Bangladesh

Contact Info

Product

Resources

About