Cost of Tuberculosis care and treatment and associated factors in West Guji Zone, Oromia Regional state, South Ethiopia

Abstract

Background: Tuberculosis (TB) is a leading cause of morbidity and mortality and the major public health concerns of several countries including Ethiopia. It mainly affects people who are active economically productive age group who are between (15-45 years), thus leading to grave socioeconomic consequences. TB patients often incur costs related to illness and health care expenses that can be barrier to access and adherence of care and treatment. Objectives: To assess cost of tuberculosis care and treatment and associated factors in West Guji zone, Oromia regional state, Southern Ethiopia, 2018. Methods: Health facility based cross-sectional cost-of-illness analysis was conducted between August13 to Sep 2 /2018 among 299 randomly selected adult TB patients who were on directly observed treatment in 16 public health facilities in West Guji zone, South Ethiopia. Data were collected using interviewer- administered questionnaire adapted from the Tool to Estimate Patients’ side Costs. Mean and median costs, reduction of productivity, and household expenditure of TB patients were calculated and ways of coping costs captured. Odds ratio and p values were used to measure association between variables. Result:-Of the total 299 TB patients enrolled, 66.2 % were smear-positive PTB, 14 % smear-negative PTB and 19.7% Extra-PTB TB cases. Direct mean and median costs of TB illness were 105.98$ (SD = 64.76$) and 105.2$(Ranges 0.18-321.79$), respectively. Indirect mean and median costs were 153.22$(SD =180.48$) and 91.22$ (Ranges 10.37-1055.22$), respectively. Mean and median total cost of TB illness to patient were 259.20$ (SD = 186.85$) and 211.17$ (Ranges 37.71-1185.6$) respectively. Of the total cost, the indirect and direct costs respectively constituted 59.12% and 40.88%. The total cost had significant association with patient’s residence, ways of transportation, DOTs distance and place where diagnosis made (P <0.05). Conclusion and Recommendation: Even though free drugs of TB treatment, Tb patients incurred terrible costs goes beyond them and their family. So, it desires introducing new innovative integrated patient- centered care with comprehensive health insurance coverage, financial incentives and nutrition support to TB patients.