Tuberculosis patients face high treatment support costs in Colombia, 2021.

<h4>Objective</h4>To estimate the baseline to measure one of the three indicators of the World Health Organization (WHO) End TB strategy (2015-2035), measure the costs incurred by patients affected by tuberculosis (TB) during a treatment episode and estimate the proportion of households...

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Main Authors: Oscar Andrés Cruz Martínez, Ingrid García, Gloria Mercedes Puerto, Nelson J Alvis-Zakzuk, Martha Patricia López, Juan Carlos Moreno Cubides, Ángela María Sánchez Salazar, Julián Trujillo Trujillo, Claudia Marcela Castro-Osorio, Vivian Vanessa Rubio, Carlos Castañeda-Orjuela, Ernesto Montoro, Peter Nguhiu, Inés García Baena
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0296250&type=printable
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author Oscar Andrés Cruz Martínez
Ingrid García
Gloria Mercedes Puerto
Nelson J Alvis-Zakzuk
Martha Patricia López
Juan Carlos Moreno Cubides
Ángela María Sánchez Salazar
Julián Trujillo Trujillo
Claudia Marcela Castro-Osorio
Vivian Vanessa Rubio
Carlos Castañeda-Orjuela
Ernesto Montoro
Peter Nguhiu
Inés García Baena
author_facet Oscar Andrés Cruz Martínez
Ingrid García
Gloria Mercedes Puerto
Nelson J Alvis-Zakzuk
Martha Patricia López
Juan Carlos Moreno Cubides
Ángela María Sánchez Salazar
Julián Trujillo Trujillo
Claudia Marcela Castro-Osorio
Vivian Vanessa Rubio
Carlos Castañeda-Orjuela
Ernesto Montoro
Peter Nguhiu
Inés García Baena
author_sort Oscar Andrés Cruz Martínez
collection DOAJ
description <h4>Objective</h4>To estimate the baseline to measure one of the three indicators of the World Health Organization (WHO) End TB strategy (2015-2035), measure the costs incurred by patients affected by tuberculosis (TB) during a treatment episode and estimate the proportion of households facing catastrophic costs (CC) and associated risk factors, in Colombia, 2021.<h4>Material and methods</h4>A nationally representative cross-sectional survey was conducted among participants on TB treatment in Colombia, using telephone interviews due to the exceptional context of the COVID-19 pandemic. The survey collected household costs (direct [medical and non-medical out-of-pocket expenses] and indirect) over an episode of TB, loss of time, coping measures, self-reported income, and asset ownership. Total costs were expressed as a proportion of annual household income and analyzed for risk factors of CC (defined as costs above 20% annual household income).<h4>Results</h4>The proportion of TB-affected households incurring in costs above 20% annual household income (CC) was 51.7% (95%CI: 45.4-58.0) overall, 51.3% (95%CI: 44.9-57.7) among patients with drug-sensitive (DS) TB, and 65.0% (95%CI: 48.0-82.0) among drug-resistant (DR). The average patient cost of a TB case in Colombia was $1,218 (95%CI 1,106-1,330) including $860.9 (95%CI 776.1-945.7) for non-medical costs, $339 (95%CI 257-421) for the indirect costs, and $18.1 (95%CI 11.9-24.4) for the medical costs. The factors that influenced the probability of facing CC were income quintile, job loss, DR-TB patient, and TB type.<h4>Conclusion</h4>Main cost drivers for CC were non-medical out-of-pocket expenses and income loss (indirect costs). Current social protection programs ought to be expanded to mitigate the proportion of TB-affected households facing CC in Colombia, especially those with lower income levels.
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issn 1932-6203
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publishDate 2024-01-01
publisher Public Library of Science (PLoS)
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spelling doaj-art-2fd69675ac814c1eabdb317ea4e15d072025-08-20T03:25:18ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01194e029625010.1371/journal.pone.0296250Tuberculosis patients face high treatment support costs in Colombia, 2021.Oscar Andrés Cruz MartínezIngrid GarcíaGloria Mercedes PuertoNelson J Alvis-ZakzukMartha Patricia LópezJuan Carlos Moreno CubidesÁngela María Sánchez SalazarJulián Trujillo TrujilloClaudia Marcela Castro-OsorioVivian Vanessa RubioCarlos Castañeda-OrjuelaErnesto MontoroPeter NguhiuInés García Baena<h4>Objective</h4>To estimate the baseline to measure one of the three indicators of the World Health Organization (WHO) End TB strategy (2015-2035), measure the costs incurred by patients affected by tuberculosis (TB) during a treatment episode and estimate the proportion of households facing catastrophic costs (CC) and associated risk factors, in Colombia, 2021.<h4>Material and methods</h4>A nationally representative cross-sectional survey was conducted among participants on TB treatment in Colombia, using telephone interviews due to the exceptional context of the COVID-19 pandemic. The survey collected household costs (direct [medical and non-medical out-of-pocket expenses] and indirect) over an episode of TB, loss of time, coping measures, self-reported income, and asset ownership. Total costs were expressed as a proportion of annual household income and analyzed for risk factors of CC (defined as costs above 20% annual household income).<h4>Results</h4>The proportion of TB-affected households incurring in costs above 20% annual household income (CC) was 51.7% (95%CI: 45.4-58.0) overall, 51.3% (95%CI: 44.9-57.7) among patients with drug-sensitive (DS) TB, and 65.0% (95%CI: 48.0-82.0) among drug-resistant (DR). The average patient cost of a TB case in Colombia was $1,218 (95%CI 1,106-1,330) including $860.9 (95%CI 776.1-945.7) for non-medical costs, $339 (95%CI 257-421) for the indirect costs, and $18.1 (95%CI 11.9-24.4) for the medical costs. The factors that influenced the probability of facing CC were income quintile, job loss, DR-TB patient, and TB type.<h4>Conclusion</h4>Main cost drivers for CC were non-medical out-of-pocket expenses and income loss (indirect costs). Current social protection programs ought to be expanded to mitigate the proportion of TB-affected households facing CC in Colombia, especially those with lower income levels.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0296250&type=printable
spellingShingle Oscar Andrés Cruz Martínez
Ingrid García
Gloria Mercedes Puerto
Nelson J Alvis-Zakzuk
Martha Patricia López
Juan Carlos Moreno Cubides
Ángela María Sánchez Salazar
Julián Trujillo Trujillo
Claudia Marcela Castro-Osorio
Vivian Vanessa Rubio
Carlos Castañeda-Orjuela
Ernesto Montoro
Peter Nguhiu
Inés García Baena
Tuberculosis patients face high treatment support costs in Colombia, 2021.
PLoS ONE
title Tuberculosis patients face high treatment support costs in Colombia, 2021.
title_full Tuberculosis patients face high treatment support costs in Colombia, 2021.
title_fullStr Tuberculosis patients face high treatment support costs in Colombia, 2021.
title_full_unstemmed Tuberculosis patients face high treatment support costs in Colombia, 2021.
title_short Tuberculosis patients face high treatment support costs in Colombia, 2021.
title_sort tuberculosis patients face high treatment support costs in colombia 2021
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0296250&type=printable
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