The economic effects of supporting tuberculosis-affected households in Peru

Abstract

The End TB Strategy mandates that no tuberculosis (TB)-affected households face catastrophic costs due to TB. However, evidence is limited to evaluate socioeconomic support to achieve this change in policy and practice. The objective of the present study was to investigate the economic effects of a TB-specific socioeconomic intervention.The setting was 32 shantytown communities in Peru. The participants were from households of consecutive TB patients throughout TB treatment administered by the national TB programme. The intervention consisted of social support through household visits and community meetings, and economic support through cash transfers conditional upon TB screening in household contacts, adhering to TB treatment/chemoprophylaxis and engaging with social support. Data were collected to assess TB-affected household costs. Patient interviews were conducted at treatment initiation and then monthly for 6 months.From February 2014 to June 2015, 312 households were recruited, of which 135 were randomised to receive the intervention. Cash transfer total value averaged US$173 (3.5% of TB-affected households' average annual income) and mitigated 20% of households' TB-related costs. Households randomised to receive the intervention were less likely to incur catastrophic costs (30% (95% CI 22–38%) versus 42% (95% CI 34–51%)). The mitigation impact was higher among poorer households.The TB-specific socioeconomic intervention reduced catastrophic costs and was accessible to poorer households. Socioeconomic support and mitigating catastrophic costs are integral to the End TB strategy, and our findings inform implementation of these new policies.

Mobile phone interventions for tuberculosis should ensure access to mobile phones to enhance equity – a prospective, observational cohort study in Peruvian shantytowns

“…Firstly, we were unable to account for changes in mobile phone access over the course of each patient's illness. A high proportion of patients with TB in Peru incur TB‐related catastrophic costs and report dissaving behaviours to cope with the financial burden associated with their disease . This may mean that when challenged by TB‐associated direct and indirect costs they must sell their phone, give up their network subscription or not have enough phone credit to communicate during the time that they are unwell.…”

Treatment outcomes of TB‐infected individuals attending public sector primary care clinics in rural Liberia from 2015 to 2017: a retrospective cohort study

“…A study in India showed that patients who received monthly food rations had a 50% lower risk of unsuccessful treatment outcomes than those who received no food support . Another study showed that patients who receive socio‐economic support are more likely to complete treatment and be ‘cured’ and less likely to incur catastrophic costs . Thus, in our study transportation reimbursement and nutritional support could be important factors contributing to improved outcomes during the CHW intervention.…”

The Retrospective Evaluation of Tuberculosis Cases in Mardin Between 2012 And 2018

“…Infection of patients ends practically in 2-3 weeks with effective treatment. (1,2) According to the report of the World Health Organization: 10.4 million people were infected with tuberculosis in 2016 and 1.7 million people died due to tuberculosis. (2) As in developing countries, TB still remains a major problem in our country.…”

“…(1,2) According to the report of the World Health Organization: 10.4 million people were infected with tuberculosis in 2016 and 1.7 million people died due to tuberculosis. (2) As in developing countries, TB still remains a major problem in our country. In particular, the insufficiency of TB diagnosis, treatment and follow-up has begun to pose a significant threat to public health.…”