title: Patient costs during tuberculosis treatment in Bangladesh and Tanzania: the potential of shorter regimens.
abstract: OBJECTIVE
  To estimate the costs incurred by patients during the intensive and continuation phases of the current 6-month tuberculosis (TB) regimen in Bangladesh and Tanzania, and thus identify potential benefits to patients of a shorter, 4-month treatment regimen.
  
  
  METHODS
  The validated Stop TB patient cost questionnaire was adapted and used in interviews with 190 patients in the continuation phase of treatment with current regimens.
  
  
  RESULTS
  In both countries, overall patient costs were lower during 2 months of the continuation phase (US$74 in Tanzania and US$56 in Bangladesh) than during the 2 months of the intensive phase of treatment (US$150 and US$111, respectively). However, continuation phase patient costs still represented 89% and 77% of the 2-month average national income in the respective countries. Direct travel costs in some settings were kept low by local delivery system features such as community treatment observation. Lost productivity and costs for supplementary foods remained significant.
  
  
  CONCLUSIONS
  Although it is not a straightforward exercise to determine the exact magnitude of likely savings, a shorter regimen would reduce out-of-pocket expenses incurred by patients in the most recent 2 months of the continuation phase and allow an earlier return to productive activities.
authors.affiliation: <label>*</label>Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: E
authors.initials: E
authors.lastname: Gospodarevskaya
authors.affiliation: <label>*</label>Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: O
authors.initials: O
authors.lastname: Tulloch
authors.affiliation: <label><sup>†</sup></label>National Institute for Medical Research, Mwanza, Tanzania.
authors.forename: C
authors.initials: C
authors.lastname: Bunga
authors.affiliation: <label><sup>‡</sup></label>BRAC Health Nutrition and Population Programme, BRAC Centre, Dhaka, Bangladesh.
authors.forename: S
authors.initials: S
authors.lastname: Ferdous
authors.affiliation: <label><sup>†</sup></label>National Institute for Medical Research, Mwanza, Tanzania.
authors.forename: A
authors.initials: A
authors.lastname: Jonas
authors.affiliation: <label><sup>‡</sup></label>BRAC Health Nutrition and Population Programme, BRAC Centre, Dhaka, Bangladesh.
authors.forename: S
authors.initials: S
authors.lastname: Islam
authors.affiliation: <label><sup>§</sup></label>National Tuberculosis Control Programme, Dhaka, Bangladesh.
authors.forename: M
authors.initials: M
authors.lastname: Rahman
authors.affiliation: <label><sup>§</sup></label>National Tuberculosis Control Programme, Dhaka, Bangladesh.
authors.forename: M A
authors.initials: MA
authors.lastname: Hussain
authors.affiliation: <label><sup>§</sup></label>National Tuberculosis Control Programme, Dhaka, Bangladesh.
authors.forename: M N
authors.initials: MN
authors.lastname: Haque
authors.affiliation: <label><sup>¶</sup></label>National Tuberculosis and Leprosy Programme, Ministry of Health and Social Welfare, Dar es Salaam, Tanzania.
authors.forename: S
authors.initials: S
authors.lastname: Egwaga
authors.affiliation: <label><sup>#</sup></label>TB Alliance, New York, New York, USA.
authors.forename: E
authors.initials: E
authors.lastname: Gardiner
authors.affiliation: <label><sup>†</sup></label>National Institute for Medical Research, Mwanza, Tanzania.
authors.forename: G
authors.initials: G
authors.lastname: PrayGod
authors.affiliation: <label><sup>‡</sup></label>BRAC Health Nutrition and Population Programme, BRAC Centre, Dhaka, Bangladesh.
authors.forename: M A
authors.initials: MA
authors.lastname: Islam
authors.affiliation: <label>*</label>Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: G H
authors.initials: GH
authors.lastname: Mann
authors.affiliation: <label><sup>#</sup></label>TB Alliance, New York, New York, USA.
authors.forename: W A
authors.initials: WA
authors.lastname: Wells
authors.affiliation: <label>*</label>Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: S B
authors.initials: SB
authors.lastname: Squire
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D001459:Bangladesh; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D016527:Drug Costs; D004526:Efficiency; D005260:Female; D005382:Financing, Personal / Q000191:economics*; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires; D013636:Tanzania; D013997:Time Factors; D014195:Travel / Q000191:economics*; D014376:Tuberculosis / Q000188:drug therapy* / Q000191:economics
chemical_list: D000995:Antitubercular Agents