title: Free tuberculosis diagnosis and treatment are not enough: patient cost evidence from three continents.
abstract: METHODS
  The National Tuberculosis Programs of Ghana, Viet Nam and the Dominican Republic.
  
  
  OBJECTIVE
  To assess the direct and indirect costs of tuberculosis (TB) diagnosis and treatment for patients and households.
  
  
  METHODS
  Each country translated and adapted a structured questionnaire, the Tool to Estimate Patients' Costs. A random sample of new adult patients treated for at least 1 month was interviewed in all three countries.
  
  
  RESULTS
  Across the countries, 27-70% of patients stopped working and experienced reduced income, 5-37% sold property and 17-47% borrowed money due to TB. Hospitalisation costs (US$42-118) and additional food items formed the largest part of direct costs during treatment. Average total patient costs (US$538-1268) were equivalent to approximately 1 year of individual income.
  
  
  CONCLUSIONS
  We observed similar patterns and challenges of TB-related costs for patients across the three countries. We advocate for global, united action for TB patients to be included under social protection schemes and for national TB programmes to improve equitable access to care.
authors: Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands. vmauch@yahoo.de
authors: V
authors: V
authors: Mauch
authors: F
authors: F
authors: Bonsu
authors: M
authors: M
authors: Gyapong
authors: E
authors: E
authors: Awini
authors: P
authors: P
authors: Suarez
authors: B
authors: B
authors: Marcelino
authors: R E
authors: RE
authors: Melgen
authors: K
authors: K
authors: Lönnroth
authors: N V
authors: NV
authors: Nhung
authors: N B
authors: NB
authors: Hoa
authors: E
authors: E
authors: Klinkenberg
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000191:economics* / Q000627:therapeutic use; D001431:Bacteriological Techniques / Q000191:economics*; D015897:Comorbidity; D017281:Cost of Illness; D004032:Diet / Q000191:economics; D004293:Dominican Republic / Q000453:epidemiology; D016527:Drug Costs; D005260:Female; D005382:Financing, Personal; D005869:Ghana / Q000453:epidemiology; D017048:Health Care Costs; D019538:Health Care Surveys; D005102:Health Expenditures; D006297:Health Services Accessibility / Q000191:economics*; D054625:Healthcare Disparities / Q000191:economics*; D017721:Hospital Costs; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents