Tuberculosis

The economic burden of TB-affected households in DR Congo: Ingenta Connect

BACKGROUND: The Democratic Republic of Congo´s free TB care policy and recent progress with universal health coverage are insufficient to remove barriers to TB care access and adherence. As there were no nationally representative data on the economic burden borne by TB
patients, the TB programme conducted a national survey to assess the proportion of TB patients facing catastrophic costs, which could also serve as a baseline for monitoring progress.
METHODS: A national survey with retrospective data collection and projection, following WHO methods,
was administered to 1,118 patients in 43 treatment zones. Each patient was interviewed once on costs, time loss, coping measures, income, household expenditure and asset ownership. Total costs were expressed as a percentage of annual household expenditure.
RESULTS: In 2019, 56.5%
of households affected by TB experienced costs above 20% of their annual household expenditure. Mean costs amounted to respectively US$400 (range: 328 471) and US$1,224 (range: 762 1,686) per episode of first-line and drug-resistant TB. The risk of catastrophic costs
increased with hospitalisation, drug resistance status and lower economic status. Half of households resorted to coping strategies and experienced food insecurity. Only 7.5% received social support.
CONCLUSION: TB-affected households incur on average a cost of US$549, despite
free TB care policy. Mitigating this burden with medical cost reductions, social and labour market measures will be key.

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Keywords:
DR Congo;
catastrophic cost;
out-of-pocket expenditures;
patient costs;
survey;
tuberculosis

Document Type: Research Article

Affiliations:
1:
Programme National de Lutte contre la Tuberculose, Ministére de la Santé Publique, Kinshasa, DR Congo, Service de Microbiologie, Département de Biologie médicale, Université de Kinshasa, Kinshasa, DR Congo
2:
World Health Organization, DR Congo Office, Kinshasa, DR Congo
3:
Institut National de Statistique, Ministère du Plan, Kinshasa, DR Congo
4:
Programme National des Comptes Nationaux de la Santé, Ministère de la Santé Publique, Kinshasa, DR Congo
5:
Health Economics Research Unit, Kenya Medical Research Institute – Wellcome Trust Research Programme, Nairobi, Kenya
6:
Global TB Programme, World Health Organization, Geneva, Switzerland

Publication date:
01 November 2021

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

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