Patients' costs associated with seeking and accessing treatment for drug-resistant tuberculosis in South Africa.


Ramma, L; Cox, H; Wilkinson, L; Foster, N; Cunnama, L; Vassall, A; Sinanovic, E; (2015) Patients' costs associated with seeking and accessing treatment for drug-resistant tuberculosis in South Africa. The international journal of tuberculosis and lung disease, 19 (12). pp. 1513-9. ISSN 1027-3719 DOI: https://doi.org/10.5588/ijtld.15.0341

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Abstract

South Africa is one of the world's 22 high tuberculosis (TB) burden countries, with the second highest number of notified rifampicin-resistant TB (R(R)-TB) and multidrug-resistant TB (MDR-TB) cases. To estimate patient costs associated with the diagnosis and treatment of R(R)-TB/MDR-TB in South Africa. Patients diagnosed with R(R)-TB/MDR-TB and accessing care at government health care facilities were surveyed using a structured questionnaire. Direct and indirect costs associated with accessing R(R)-TB/MDR-TB care were estimated at different treatment durations for each patient. A total of 134 patients were surveyed: 84 in the intensive phase and 50 in the continuation phase of treatment, 82 in-patients and 52 out-patients. The mean monthly patient costs associated with the diagnosis and treatment of R(R)-TB/MDR-TB were higher during the intensive phase than the continuation phase (US$235 vs. US$188) and among in-patients than among out-patients (US$269 vs. US$122). Patients in the continuation phase and those accessing care as out-patients reported higher out-of-pocket costs than other patients. Most patients did not access social protection for costs associated with R(R)-TB/MDR-TB illness. Despite free health care, patients bear high costs when accessing diagnosis and treatment services for R(R)-TB/MDR-TB; appropriate social protection mechanisms should be provided to assist them in coping with these costs.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Global Health and Development
Research Centre: Social and Mathematical Epidemiology (SaME)
SaME Modelling & Economics
TB Centre
PubMed ID: 26614194
Web of Science ID: 365837100018
URI: http://researchonline.lshtm.ac.uk/id/eprint/2373906

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