Assessment of the Indirect Cost of Drug Resistant Tuberculosis Treatment to Patients in a High Burden, Low Income Setting in Mozambique  

作　　者：Júlia Malache António Domingas Pacala Isabelle Munyangaju Isaías Benzana Claudia Mutaquiha Dulce Osório Benedita José Edy Nacarapa Pereira Zindoga Júlia Malache António;Domingas Pacala;Isabelle Munyangaju;Isaías Benzana;Claudia Mutaquiha;Dulce Osório;Benedita José;Edy Nacarapa;Pereira Zindoga(Faculdade de Cincias de Sade, Universidade Catlica de Moambique, Beira, Moambique;Programa Nacional de Controlo da Tuberculose, Ministrio da Sade de Moambique, Maputo, Moambique;ISGlobal, Hospital Clnic, Universitat de Barcelona, Barcelona, Spain;Tinpswalo Association, Vincentian Association to Fight AIDS and TB, Chokwe, Mozambique;Centro de Estudos e Apoio Psicolgico (CEAP), Universidade Eduardo Mondlane, Maputo, Moambique)

机构地区：[1]Faculdade de Cincias de Sade, Universidade Catlica de Moambique, Beira, Moambique [2]Programa Nacional de Controlo da Tuberculose, Ministrio da Sade de Moambique, Maputo, Moambique [3]ISGlobal, Hospital Clnic, Universitat de Barcelona, Barcelona, Spain [4]Tinpswalo Association, Vincentian Association to Fight AIDS and TB, Chokwe, Mozambique [5]Centro de Estudos e Apoio Psicolgico (CEAP), Universidade Eduardo Mondlane, Maputo, Moambique

出　　处：《Journal of Tuberculosis Research》2024年第2期91-104,共14页结核病研究（英文）

摘　　要：Introduction: Tuberculosis is closely linked to poverty, with patients facing significant indirect treatment costs. Treating drug-resistant tuberculosis further increases these expenses. Notably, there is a lack of published data on the indirect costs incurred by patients with drug-resistant tuberculosis in Mozambique. Objective: To assess the indirect costs, income reduction, and work productivity incurred by patients undergoing diagnosis and treatment for Drug-Resistant Tuberculosis (DRTB) in Mozambique during their TB treatment. Methods: As part of a comprehensive mixed-methods study conducted from January 2021 to April 2023, this research utilized a descriptive cross-sectional approach, incorporating both quantitative and qualitative methods. The primary goal was to evaluate the costs incurred by the national health system due to drug-resistant TB. Additionally, to explore the indirect costs experienced by patients and their families during treatment, semi-structured interviews were conducted with 27 individuals who had been undergoing treatment for over six months. Results: All survey participants unanimously reported a significant decline in labour productivity, with 70.3% experiencing a reduction in their monthly income. Before falling ill, the majority of respondents (33.3%) earned up to $76.92 monthly, representing the minimum earnings range, while 29.2% had a monthly income above $230.77, the maximum earnings range. Among those who experienced income loss, the majority (22.2%) reported a decrease of up to $76.92 per month, and 18.5% cited a loss exceeding $230.77 per month. Notably, patients with Drug-Resistant Tuberculosis (DRTB) have not incurred the direct costs of the disease, as these are covered by the government. Conclusion: The financial burden of treating Drug-Resistant Tuberculosis (DRTB), along with the income reduction it causes, is substantial. Implementing a patient-centred, multidisciplinary, and multisector approach, coupled with strong psychosocial support, can significantly reduce the Introduction: Tuberculosis is closely linked to poverty, with patients facing significant indirect treatment costs. Treating drug-resistant tuberculosis further increases these expenses. Notably, there is a lack of published data on the indirect costs incurred by patients with drug-resistant tuberculosis in Mozambique. Objective: To assess the indirect costs, income reduction, and work productivity incurred by patients undergoing diagnosis and treatment for Drug-Resistant Tuberculosis (DRTB) in Mozambique during their TB treatment. Methods: As part of a comprehensive mixed-methods study conducted from January 2021 to April 2023, this research utilized a descriptive cross-sectional approach, incorporating both quantitative and qualitative methods. The primary goal was to evaluate the costs incurred by the national health system due to drug-resistant TB. Additionally, to explore the indirect costs experienced by patients and their families during treatment, semi-structured interviews were conducted with 27 individuals who had been undergoing treatment for over six months. Results: All survey participants unanimously reported a significant decline in labour productivity, with 70.3% experiencing a reduction in their monthly income. Before falling ill, the majority of respondents (33.3%) earned up to $76.92 monthly, representing the minimum earnings range, while 29.2% had a monthly income above $230.77, the maximum earnings range. Among those who experienced income loss, the majority (22.2%) reported a decrease of up to $76.92 per month, and 18.5% cited a loss exceeding $230.77 per month. Notably, patients with Drug-Resistant Tuberculosis (DRTB) have not incurred the direct costs of the disease, as these are covered by the government. Conclusion: The financial burden of treating Drug-Resistant Tuberculosis (DRTB), along with the income reduction it causes, is substantial. Implementing a patient-centred, multidisciplinary, and multisector approach, coupled with strong psychosocial support, can significantly reduce the

关 键 词：Economic Costs Drug Resistance TUBERCULOSIS Catastrophic Costs 

分 类 号：R52[医药卫生—内科学]