Table 6.
Costs for the entirety of the illness period and the prevalence of catastrophic costs from n=6 studies reporting on patient costs*
| First author, population and screening method, illness period and costs reported | Combined cost for the illness period (US$) |
Catastrophic cost prevalence |
Comments | |||||
|---|---|---|---|---|---|---|---|---|
| Screen | PCF | p-value | Screen | PCF | p-value | |||
| Muniyandi (2020); India General population; symptoms and CXR screen Diagnosis and treatment Direct (medical and non-medical) and indirect costs |
Mean (SEM) |
69 (18) |
227 (20) |
0.001 | 9% | 29% | - | Screened group more likely to be older, illiterate, smoke and report no symptoms. No data on bacteriological status. On adjusted analysis catastrophic costs were significantly higher among the PCF group (aOR 3.68; 95%CI 1.62-8.33) |
| Gurung (2019); Nepal OPD attendees, social contacts of people with TB, general population TB camps; symptom screen Pre-treatment (from symptom start) and intensive treatment phase Direct (medical and non-medical) and indirect costs |
Median (IQR) | 253 (81–453) |
315 (126–544) |
0.16 | 45% | 61% | 0.14 | 60% OPD; 34% social contacts; 6% camps No difference in socio-demographic, disease and health seeking characteristics between groups. PCF group interviewed >1 month after treatment start (∼70%) reported lower costs than those interviewed within 1 month. No difference seen with screened group. |
| Shewade (2018); India Marginalised/vulnerable populations⁎⁎; symptom screen From sputum eligible¶ to diagnosis Direct (medical and non-medical) and indirect costs |
Median (IQR) | 5 (0-40) |
20 (4-69) |
<0.001 | 10% | 12% | - | Screened group more likely to be older, from rural residence, have no formal education, have lower median monthly income and not report weight loss. No significant difference in smear grade, weight in Kg, haemoptysis or fever between screened and PCF group On adjusted analysis catastrophic costs were significantly lower among the screened group (aPR 0.68; 95%CI 0.69-0.97) |
| Morishita (2016); Cambodia HH and neighbourhood contacts; CXR screen Pre-treatment and during 6 months of treatment Direct (medical and non-medical) and indirect costs |
Median (IQR) | 241 (66–595) |
290 (114–813) |
0.10 | 36% | 45% | 0.24 | No difference in socio-demographic characteristics. PCF group more likely to be smear/Xpert positive and live near health centres. No other clinical data provided |
| Hussain (2019); Pakistan HCW - incentives; clinic attendees – symptom screen; general population – TB IEC Pre-diagnosis, diagnosis and treatment phase Direct (medical, non-medical) and indirect costs |
Mean† | 59 | 71 | NR | NR | 52% smear negative in screened group and 42% smear negative in PCF group | ||
| Sekandi (2015); Uganda General population; symptom screen Diagnosis Direct (non-medical) and indirect costs |
Mean (range) | 5 (2–7) |
29 (14–43) |
NR | NR | |||
All values (costs and proportions) rounded to the nearest whole number; PCF=passive case-finding; CXR=chest radiograph; SEM=standard error of the mean; aOR=adjusted odds ratio; 95%CI=95% confidence interval; OPD=outpatient department; IQR=interquartile range
included slums, tribal areas, scheduled caste communities, areas where occupational lung diseases is high, areas where individuals with high risk of acquiring TB reside including stone crushing/mining/weaving industry/unorganized labour (construction workers etc)/homeless, high HIV/AIDS burden areas, areas or communities with high TB incidence (including prisons) and among household contacts of sputum smear positive TB patients
from 15th day of continuous cough, fever or the day of the 1st episode of haemoptysis; aPR=adjusted prevalence ratio; HH=household; HCWs=health care workers; IEC=information, education and communication
no measure of spread reported; NR=not reported