Abstract:
Background: Tuberculosis is a global health problem. Worldwide in low- and middle income
countries the total funding for tuberculosis prevention, diagnostic and treatment reached US$6.9
billion in 2018, an increase from US$6.2 billion in 2017 and the median cost per patient treated in
2017 was US$ 1224 for drug-susceptible tuberculosis and US$ 7141 for drug resistance
tuberculosis. Previous studies conducted in Ethiopia were addressing only patients side cost and
included only public health facilities. This study includes companion side costs and private health
facilities cost of TB patient.
Objective: This study is aimed to determine cost of tuberculosis to patients and their family in
Adama town, Ethiopia.
Methods: Facility based cross-sectional study design was employed and cost of illness study on
229 tuberculosis cases at health facilities in Adama town was conducted using interveiwer
administered semi-structured questionnaire. A systematic random sampling technique was
employed to select study participants. We employed a micro-costing bottom–up approach in order
to estimate direct cost of tuberculosis. Indirect costs for the study participants and their
accompanyins persons were calculated interms of productive time losses, using human capital
approach. The data cleaning and entry was undertaken using Epi data 3.1 and analyze using
SPSS-20 statistical software, and result was presented using descriptive statistics like, frequency,
percentage, mean, standared divetion, median and intr-quartertile range. The Ethical approval was
obtained from the Institutional Review board of the Jimma University, legal letters from respected
organization and oral informed consent from study participants.
Result: A total 229 TB patients were interviewed, 45.4% were smear-positive pulmonary TB,
28.4% smear-negative pulmonary TB, 24.9% Extra-pulmonary TB and 1.3% was multi-drug
resistance TB cases. The total mean direct cost of TB patient was ETB 5784.01 (USD 210.54)
with SD 4019.12 (USD 146.30). Of direct costs, direct non-medical cost accounted 73.5% of the
total mean direct costs of TB patients. The total mean indirect cost was ETB 5481.61 (USD
199.53) with SD of ETB 6588.48 (USD 239.82). The total mean and median cost of TB illness to
patient and accompanyins were ETB 11265.62 (USD 410.08) with SD of ETB 9286.68 (338.05)
and ETB 8870.0 (USD 322.88) with IQR of ETB(6097.50,14140), respectively.
Conclusion: Tuberculosis patients incur substantial cost for care seeking and treatment despite
the availability of free of charge anti-TB drug. Direct non-medical costs and indirect costs were
high cost on tuberculosis patients.
