Table 2. Direct out-of-pocket cost for tuberculosis in every stage of the patient care pathway (in USD).

Category	Participants*	Share of overalldirect cost acrossstages (%)**	Direct cost(in USD), All	Direct cost(in USD), Urban	Direct cost(in USD), Rural	Regionalcomparison
Stage of thecare pathway	n1/n2 (%)	Median (iqr)	Median (iqr)	Median (iqr, n)	Median (iqr, n)	P-value
Pre-diagnosis	228/245 (93.1)	38.2 (14.0–62.1)	43.0 (14.5–118.2)	62.2 (15.6–145.2, 149)	26.0 (10.4–67.4, 79)	0.0009
Diagnosis	241/245 (98.4)	12.3*** (5.7–33.1)	13.5 (9.7–34.6)	12.4 (9.7–20.2, 156)	22.8 (9.3–76.7, 85)	0.0077
Treatmentinitiation	184/245 (75.1)	1.5*** (0.5–3.8)	2.1 (1.0–4.1)	1.7 (1.0–3.7, 123)	2.1 (1.2–4.1, 61)	0.3905
Intensivetreatment	227/245 (92.7)	28.6*** (1.0–46.5)	43·4 (20.7–95.4)	55.6 (24.9–114.1, 153)	27.0 (12.4–55.5, 74)	<0.0001
Continuationtreatment	127/153 (83.0)	13.3 (2.4–28.5)	16.6 (4.1–68.5)	29.9 (6.2–95.8, 79)	11.1 (4.1–41.3, 48)	0.0226
Total	153/153 (100.0)	–	182.9 (100.4–353.7)	256.4 (133.8–387.3, 95)	110.3 (56.0–218.0, 58)	<0.0001

Median direct costs ranged from USD 2.10 per patient for treatment initiation to USD 43.40 per patient for intensive treatment. Pre-diagnosis and intensive treatment showed the highest median costs in both regions. Rural residents also incurred high burden during diagnosis stage.

*n1 = number of patients with direct cost >0 per stage; n2 = number of patients respectively who went through up to the intensive treatment stage (245), and who went through the entire care pathway (153).

**The median (iqr) share of overall direct cost across stages by region was: 44.0% (14.1–67.6) for pre-diagnosis, 8.5% (4.3–19.3) for diagnosis, 1.1% (0.4–2.9) for treatment initiation, 30.2% (16.2–49.8) for intensive treatment and 15.4% (2.0–29.5) for continuation treatment among urban residents, and respectively 32.1% (14.1–51.7), 27.3% (11.4–52.4), 2.2% (0.9–5.7), 22.2% (13.2–41.3) and 8.6% (3.4–22.7) among rural residents.

***Distributions of proportion significantly different across region (P<0.05).