Patients direct costs to undergo TB diagnosis

Cuevas, Rachel Mary Anderson de; Lawson, Lovett; Al-Sonboli, Najla; Al-Aghbari, Nasher; Arbide, Isabel; Sherchand, Jeevan Bahadur; Nnamdi, Emenyonu E.; Aseffa, Abraham; Yassin, Mohammed A.; Abdurrahman, Saddiq T.; Obasanya, Joshua; Oladimeji, Olanrewaju; Datiko, Daniel Gemechu; Theobald, Sally; Ramsay, Andrew J.; Squire, S. Bertel; Cuevas, Luis E.

doi:10.1186/s40249-016-0117-x

Cited by 19 publications

(13 citation statements)

References 26 publications

(34 reference statements)

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“…The operational definition of various costs and indicators were summarized in Table 1. Direct costs included all costs of patients and companions attributable to their illness [10]. Indirect costs referred to the income lost by patients and their companions associated with time lost off work.…”

Section: Measurements and Definitionsmentioning

confidence: 99%

Analysis of the economic burden of diagnosis and treatment on patients with tuberculosis in Bao’an district of Shenzhen City, China

Huang

et al. 2020

PLoS ONE

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Background Illness-related costs experienced by tuberculosis patients produce a severe economic impact on households, especially poor families. Few studies have investigated the full costs, including direct and indirect costs, at the patient and household levels in southeast China. Methods A case follow-up study was conducted in the Bao'an district of Shenzhen City, China. Eligible new and previously treated individuals with pulmonary tuberculosis (TB) during January 1 st 2013 to June 30 th 2013 were enrolled. Medical and non-medical costs as well as income loss were calculated in diagnosis and treatment periods, respectively. Factors associated with costs due to TB diagnosis, treatment and TB care (diagnosis + treatment) were explored respectively with a linear regression model. Results Of the total 514 TB patients enrolled, 95% were from the migrant population, and 65% were males, with a mean age of 32.25 (±10.11). The median costs due to TB diagnosis and TB treatment were 79 United States dollar (USD), 748USD (6.2897 China Yuan (CNY) = 1USD, 2013) per patient, respectively. The median costs due to TB care (diagnosis and treatment) per patient was 1218USD, corresponding to 26% of patients' annual income preillness. Those who visited more times to health facilities, hospitalized, received higher education, or occupied in national civil servant/services/retired staff might expense more before diagnosis. Costs due to TB treatment was significantly higher among migrant patients, sputum smear positive patients, and widowed/divorced population. Factors associated with less total costs were native patients, fewer times of visiting to health-care facilities and those with no hospitalization history due to TB.

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Section: Measurements and Definitionsmentioning

confidence: 99%

Analysis of the economic burden of diagnosis and treatment on patients with tuberculosis in Bao’an district of Shenzhen City, China

Huang

et al. 2020

PLoS ONE

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“…A study conducted on cost faced by TB/MDR-TB in Ethiopia shows 76% of TB Patients and 72% of MDR-TB lost their job, 36% Patients hospitalized for TB and 82% for MDR-TB, 92% of patients reporting income loss due to TB and 79% due to MDR-TB and 24% of patients sold property due to TB and 38% due to MDR-TB. Costs paid for clinic and cost of transportation were the significant factor related to cost of TB treatment [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Role of Health Extension Worker in Tuberculosis Prevention and Control in Ethiopia: Systematic Review

Weldemarium¹

2019

AJLS

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Background: Health Extension Program was designed to serve the rural community of Ethiopia and has brought significant change in improving utilization of family planning, antenatal care, postnatal care, birth preparedness, initiating breast feeding immediately after birth and HIV testing. In relation to Tuberculosis (TB) prevention and control, TB patients believe that they learnt about TB from HEWs and some patients stated that they could not have been diagnosed without the work of HEWs. HEWs focus on Education of the community, Identification of suspects, referral of suspects to health Facilities, Support for adherence to treatment, retrieval of absentees and contact tracing. Objective: The objective of this review was to assess the role of Ethiopian health extension workers in prevention and control of TB. Method: Computerized systematic search was conducted through PubMed, Google Scholar, and Science direct databases. After reviewing for relevance of articles based on title, abstract and eliminating for redundancies five articles were included for this review. Studies presented to the original article, studies that examine contribution of HEWs to TB prevention, studies conducted in Ethiopia; studies written in English were included in the review. Results: Large number of people with TB symptom which is the base for TB prevention and elimination strategy was identified by the HEWs. The health extension workers identified not only new patients but also the retreatment (defaulters) which are the major contributors to (multi drug resistant TB (MDR-TB). From the identified TB suspects by HEWs, majority of them were found to be positive for the disease. Health extension worker remain the health worker who identify TB suspects and refer patient to health facilities. They were also the source of community health educator in relation to TB.

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“…In resource-limited areas, travel time and costs associated with accessing healthcare facilities can be a considerable burden to patients being investigated for tuberculosis (TB) and their families [ 1 – 3 ]. The financial burden can equal several months’ salary and may therefore exacerbate or push people into poverty [ 4 , 5 ]. These costs apply equally to patients found to have TB, and to the vast majority who have an alternative cause for their symptoms.…”

Section: Introductionmentioning

confidence: 99%

Spot sputum samples are at least as good as early morning samples for identifying Mycobacterium tuberculosis

Murphy

Phillips

Mendel

et al. 2017

BMC Med

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BackgroundThe use of early morning sputum samples (EMS) to diagnose tuberculosis (TB) can result in treatment delay given the need for the patient to return to the clinic with the EMS, increasing the chance of patients being lost during their diagnostic workup. However, there is little evidence to support the superiority of EMS over spot sputum samples. In this new analysis of the REMoxTB study, we compare the diagnostic accuracy of EMS with spot samples for identifying Mycobacterium tuberculosis pre- and post-treatment.MethodsPatients who were smear positive at screening were enrolled into the study. Paired sputum samples (one EMS and one spot) were collected at each trial visit pre- and post-treatment. Microscopy and culture on solid LJ and liquid MGIT media were performed on all samples; those missing corresponding paired results were excluded from the analyses.ResultsData from 1115 pre- and 2995 post-treatment paired samples from 1931 patients enrolled in the REMoxTB study were analysed. Patients were recruited from South Africa (47%), East Africa (21%), India (20%), Asia (11%), and North America (1%); 70% were male, median age 31 years (IQR 24–41), 139 (7%) co-infected with HIV with a median CD4 cell count of 399 cells/μL (IQR 318–535). Pre-treatment spot samples had a higher yield of positive Ziehl–Neelsen smears (98% vs. 97%, P = 0.02) and LJ cultures (87% vs. 82%, P = 0.006) than EMS, but there was no difference for positivity by MGIT (93% vs. 95%, P = 0.18). Contaminated and false-positive MGIT were found more often with EMS rather than spot samples. Surprisingly, pre-treatment EMS had a higher smear grading and shorter time-to-positivity, by 1 day, than spot samples in MGIT culture (4.5 vs. 5.5 days, P < 0.001). There were no differences in time to positivity in pre-treatment LJ culture, or in post-treatment MGIT or LJ cultures. Comparing EMS and spot samples in those with unfavourable outcomes, there were no differences in smear or culture results, and positive results were not detected earlier in Kaplan–Meier analyses in either EMS or spot samples.ConclusionsOur data do not support the hypothesis that EMS samples are superior to spot sputum samples in a clinical trial of patients with smear positive pulmonary TB. Observed small differences in mycobacterial burden are of uncertain significance and EMS samples do not detect post-treatment positives any sooner than spot samples.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-017-0947-9) contains supplementary material, which is available to authorized users.

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Patients direct costs to undergo TB diagnosis

Cited by 19 publications

References 26 publications

Analysis of the economic burden of diagnosis and treatment on patients with tuberculosis in Bao’an district of Shenzhen City, China

Analysis of the economic burden of diagnosis and treatment on patients with tuberculosis in Bao’an district of Shenzhen City, China

Role of Health Extension Worker in Tuberculosis Prevention and Control in Ethiopia: Systematic Review

Spot sputum samples are at least as good as early morning samples for identifying Mycobacterium tuberculosis

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