TY - JOUR
T1 - Direct costs of pulmonary tuberculosis among patients receiving treatment in Bauchi State, Nigeria
AU - Umar, Nisser Ali
AU - Abubakar, I.
AU - Fordham, R.
AU - Bachmann, M.
PY - 2012/6/1
Y1 - 2012/6/1
N2 - BACKGROUND: To access tuberculosis (TB) services, patients have to bear the costs of out-of-pocket expenditures or direct costs for transport, drugs and other services that are not provided free-of-charge. These costs could represent a barrier to care, especially in a country such as Nigeria, where per capita gross national income is only US$1160 and 46% of the urban population live below the poverty line. OBJECTIVE: To describe the direct costs of TB diagnosis and treatment in Bauchi State, Nigeria, from the patient's perspective. METHODS: A cross-sectional study. A sample size of 255 patients was randomly selected from 27 of 67 facilities in Bauchi State, Nigeria. RESULTS: The median out-of-pocket cost for hospitalised patients was estimated at US$166.11, while ambulatory patients paid an estimated median cost of US$94.16, equivalent to about 9-38% of their average annual income. Female patients spent a higher proportion of their income on diagnosis and treatment than males (P < 0.0001). The median out-of-pocket costs borne by patients before, during and after diagnosis were estimated at respectively US$35.23, US$27.12 and US$23.43 for ambulatory patients, and additional average out-of-pocket spending of US$66.44 for patients hospitalised during their illness. Pre-diagnosis, diagnosis and post-diagnosis out-of-pocket spending did not vary significantly by human immunodeficiency virus status (P > 0.05) and sex (P > 0.05). CONCLUSION: The costs of anti-tuberculosis treatment found in this study are expensive and potentially catastrophic for many patients and their families.
AB - BACKGROUND: To access tuberculosis (TB) services, patients have to bear the costs of out-of-pocket expenditures or direct costs for transport, drugs and other services that are not provided free-of-charge. These costs could represent a barrier to care, especially in a country such as Nigeria, where per capita gross national income is only US$1160 and 46% of the urban population live below the poverty line. OBJECTIVE: To describe the direct costs of TB diagnosis and treatment in Bauchi State, Nigeria, from the patient's perspective. METHODS: A cross-sectional study. A sample size of 255 patients was randomly selected from 27 of 67 facilities in Bauchi State, Nigeria. RESULTS: The median out-of-pocket cost for hospitalised patients was estimated at US$166.11, while ambulatory patients paid an estimated median cost of US$94.16, equivalent to about 9-38% of their average annual income. Female patients spent a higher proportion of their income on diagnosis and treatment than males (P < 0.0001). The median out-of-pocket costs borne by patients before, during and after diagnosis were estimated at respectively US$35.23, US$27.12 and US$23.43 for ambulatory patients, and additional average out-of-pocket spending of US$66.44 for patients hospitalised during their illness. Pre-diagnosis, diagnosis and post-diagnosis out-of-pocket spending did not vary significantly by human immunodeficiency virus status (P > 0.05) and sex (P > 0.05). CONCLUSION: The costs of anti-tuberculosis treatment found in this study are expensive and potentially catastrophic for many patients and their families.
KW - Bauchi
KW - Cost
KW - HIV
KW - Nigeria
KW - Tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=84861133959&partnerID=8YFLogxK
U2 - 10.5588/ijtld.10.0774
DO - 10.5588/ijtld.10.0774
M3 - Article
C2 - 22613686
AN - SCOPUS:84861133959
SN - 1027-3719
VL - 16
SP - 835
EP - 840
JO - International Journal of Tuberculosis and Lung Disease
JF - International Journal of Tuberculosis and Lung Disease
IS - 6
ER -