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Int J Tuberc Lung Dis. 2012 Jun;16(6):733-9. doi: 10.5588/ijtld.11.0193. Epub 2012 Mar 8.

The economic burden of tuberculosis care for patients and households in Africa: a systematic review.

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  • 1Department of Internal Medicine, Ebonyi State University Teaching Hospital, Abakaliki, Nigeria. ukwajakingsley@yahoo.co.uk

Abstract

OBJECTIVES:

To summarise the state of knowledge on the economic impact and consequences of tuberculosis (TB) diagnosis and treatment for patients/households in Africa, and to highlight any weaknesses in the work conducted to date.

METHODS:

We systematically searched for published articles in English between 1990 and June 2010 in eight databases and the World Health Organization (WHO) website. Broad search terms were used ('tuberculosis' OR 'tuberculosis/HIV' AND 'costs' AND 'Africa'). Only studies that reported any costs of TB care for patients/households were retained. All costs were converted to 2009 USD in accordance with WHO cost analysis guidelines.

RESULTS:

Overall, 11 articles from eight countries met the inclusion criteria. Only one study met all the quality criteria for a cost-of-illness study; most of the studies focused on urban populations, reported incomplete (pre-diagnostic/average) costs, and did not report coping costs. Mean patient pre-diagnostic costs varied between US$36 and US$196, corresponding to respectively 10.4% and 35% of their annual income. Average patient treatment costs ranged between US$3 and US$662, corresponding to 0.2-30% of their annual income. Pre-diagnostic household costs accounted for 13% and 18.8% of patients' annual household income, while total household treatment costs ranged between US$26 and US$662, accounting for 2.9-9.3% of annual household income; 18-61% of patients received financial assistance from outside their household to cope with the cost of TB care.

CONCLUSION:

The average patient's/household's pre-diagnostic costs for TB care were catastrophic. More properly designed studies are needed among different populations throughout Africa.

PMID:
22410546
[PubMed - indexed for MEDLINE]
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