The economic burden of tuberculosis and latent tuberculosis in people living with HIV in Brazil: a cost study from the patient perspective

Filha, Noêmia Teixeira de Siqueira; Albuquerque, Maria de Fátima Pessoa Militão de; Legood, Rosa; Rodrigues, Laura C.; Santos, Andréia Costa

doi:10.1016/j.puhe.2017.12.011

Cited by 5 publications

(2 citation statements)

References 8 publications

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“…In India, the prevalence of catastrophic costs ranges from 4 to 68%, depending on the study setting, type of provider (government vs. private), and type of TB [ 13 , 14 ]. Studies estimating patient costs due to TB-HIV have been reported from South Africa, Ethiopia, and Brazil [ 15 – 18 ]. Studies have reported higher patient costs as well as higher catastrophic costs for combined care of TB-HIV when compared with TB alone (64% vs. 47%) [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Costs incurred by patients with tuberculosis co-infected with human immunodeficiency virus in Bhavnagar, western India: a sequential explanatory mixed-methods research

Rupani

Vyas

2022

BMC Health Serv Res

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Background India reports the highest number of tuberculosis (TB) and second-highest number of the human immunodeficiency virus (HIV) globally. We hypothesize that HIV might increase the existing financial burden of care among patients with TB. We conducted this study to estimate the costs incurred by patients with TB co-infected with HIV and to explore the perspectives of patients as well as program functionaries for reducing the costs. Methods We conducted a descriptive cross-sectional study among 234 co-infected TB-HIV patients notified in the Bhavnagar region of western India from 2017 to 2020 to estimate the costs incurred, followed by in-depth interviews among program functionaries and patients to explore the solutions for reducing the costs. Costs were estimated in Indian rupees (INR) and expressed as median (interquartile range IQR). The World Health Organization defines catastrophic costs as when the total costs incurred by patients exceed 20% of annual household income. The in-depth interviews were audio-recorded, transcribed, and analyzed as codes grouped into categories. Results Among the 234 TB-HIV co-infected patients, 78% were male, 18% were sole earners in the family, and their median (IQR) monthly family income was INR 9000 (7500–11,000) [~US$ 132 (110–162)]. The total median (IQR) costs incurred for TB were INR 4613 (2541–7429) [~US$ 69 (37–109)], which increased to INR 7355 (4337–11,657) [~US$ 108 (64–171)] on adding the costs due to HIV. The catastrophic costs at a 20% cut-off of annual household income for TB were 4% (95% CI 2–8%), which increased to 12% (95% CI 8–16%) on adding the costs due to HIV. Strengthening health systems, cash benefits, reducing costs through timely referral, awareness generation, and improvements in caregiving were some of the solutions provided by program functionaries and the patients. Conclusion We conclude that catastrophic costs due to TB-HIV co-infection were higher than that due to TB alone in our study setting. Bringing care closer to the patients would reduce their costs. Strengthening town-level healthcare facilities for diagnostics as well as treatment might shift the healthcare-seeking of patients from the private sector towards the government and thereby reduce the costs incurred.

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Section: Introductionmentioning

confidence: 99%

Costs incurred by patients with tuberculosis co-infected with human immunodeficiency virus in Bhavnagar, western India: a sequential explanatory mixed-methods research

Rupani

Vyas

2022

BMC Health Serv Res

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“…In the future, concurrent TB-HIV infection will become a burden on a country's expenses, as prolonged treatment may be required as compared to countries with only TB infection [3,9]. In 2013, the Malaysian government spent about USD15 million on TB intervention and control [10].…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis Treatment Outcome in Patients with Tb-hiv Co-infection in Kuala Lumpur, Malaysia

Selimin

Ismail²,

Ahmad

et al. 2020

Preprint

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Background: Tuberculosis (TB) is a serious health threat to people living with human immunodeficiency virus (HIV). Directly observed treatment, short course (DOTS) is one of many efforts done as part of ending TB, in which all confirmed TB sputum smear positive cases properly given treatment and monitored by the healthcare providers or family members to ensure treatment adherence. This study aimed to identify the characteristics, to determine the rate of unsuccessful TB treatment rate and to determine determinants of unsuccessful TB treatment outcome among patients with TB-HIV co-infection in Kuala Lumpur.Methods: This was a cross-sectional study. The data of all patients with TB-HIV co-infection in the federal territory of Kuala Lumpur from 2013 to 2017 were collected and reviewed. The data were retrieved from the national database (TB Information System) at the Kuala Lumpur Health Department from 1 March 2018 to 31 May 2018.Results: Out of 235 randomly selected patients with TB-HIV co-infection, TB treatment outcome was successful in 57.9% (cured and completed treatment) and unsuccessful in 42.1% (died, failed or defaulted treatment). Patients who did not receive DOTS (adjusted odds ratio [aOR] 21.71; 95% confidence interval [CI]: 5.36–87.94) and those who received shorter treatment duration of <6 months (aOR 34.54; 95% CI: 5.97–199.93) had higher odds for unsuccessful TB treatment outcome.Conclusions: Nearly half of the patients with TB-HIV co-infection had unsuccessful TB treatment outcome. Therefore, it is important to ensure that such patients receive DOTS and continuous TB treatment of >6 months. It is crucial to strengthen and widen the coverage of DOTS, especially among high-risk groups, in healthcare settings. Strict follow-up by healthcare providers is needed for patients with TB-HIV co-infection to gain treatment adherence and for better rates of successful TB treatment.

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Costing of services under National Tuberculosis Elimination Program at public health facilities of northern India

Kumar

Prinja

2023

Indian Journal of Tuberculosis

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The economic burden of tuberculosis and latent tuberculosis in people living with HIV in Brazil: a cost study from the patient perspective

Abstract: Public health policies may address ways to prevent high patients' costs through the introduction of more accurate algorithms for TB diagnosis to prevent delays in the diagnosis and treatment.

Cited by 5 publications

References 8 publications

Costs incurred by patients with tuberculosis co-infected with human immunodeficiency virus in Bhavnagar, western India: a sequential explanatory mixed-methods research

Costs incurred by patients with tuberculosis co-infected with human immunodeficiency virus in Bhavnagar, western India: a sequential explanatory mixed-methods research

Tuberculosis Treatment Outcome in Patients with Tb-hiv Co-infection in Kuala Lumpur, Malaysia

Costing of services under National Tuberculosis Elimination Program at public health facilities of northern India

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