Socio-economic impact of tuberculosis on patients and family in India.
OBJECTIVE
To quantify the socio-economic impact of tuberculosis on patients and their families from the costs incurred by patients in rural and urban areas.


METHODS
An interview schedule prepared from 17 focus group discussions was used to collect socio-economic demographic characteristics, employment, income particulars, expenditure on illness and effects on children from newly detected sputum-positive pulmonary tuberculosis patients. The direct and indirect costs included money spent on diagnosis, drugs, investigations, travel and loss of wages. Total costs were projected for the entire 6 months of treatment.


RESULTS
The study population consisted of 304 patients (government health care 202, non governmental organisation 77, private practitioner 25), 120 of whom were females. Mean direct cost was Rs.2052/-, indirect Rs.3934/-, and total cost was Rs.5986/- ($171 US). The mean number of work days lost was 83 and mean debts totalled Rs.2079/-. Both rural and urban female patients faced rejection by their families (15%). Eleven per cent of schoolchildren discontinued their studies; an additional 8% took up employment to support their family.


CONCLUSIONS
The total costs, and particularly indirect costs due to TB, were relatively high. The average period of loss of wages was 3 months. Care giving activities of female patients decreased significantly, and a fifth of schoolchildren discontinued their studies.
Rajeswari
R
R
Tuberculosis Research Centre, Indian Council of Medical Research, Chetput, Chennai, India. trcicmr@giasmd01.vsnl.net.in
Balasubramanian
R
R
Muniyandi
M
M
Geetharamani
S
S
Thresa
X
X
Venkatesan
P
P
D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D003365:Costs and Cost Analysis; D003710:Demography; D005190:Family / Q000208:ethnology; D005260:Female; D017144:Focus Groups; D006801:Humans; D007194:India; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics* / Q000208:ethnology