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Can patients afford the cost of treatment for multidrug-resistant tuberculosis in Ethiopia?

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SETTING: Ethiopia has a high prevalence of tuberculosis (TB) and is one of the countries with the highest burden of multidrug-resistant TB (MDR-TB).

OBJECTIVE: To understand the costs that patients incur in obtaining diagnosis and treatment for MDR-TB.

DESIGN: In March 2013, interviews were conducted with 169 MDR-TB patients at three hospitals in Ethiopia to identify the cost to patients and the impact on employment and family income.

RESULTS: The average MDR-TB patient incurred a total cost of US$1378, which represented 25 months of a mid-treatment household income of US$54. The impact on the patient's employment and on overall patient and family income was generally catastrophic: 74% of all respondents reported losing their jobs, 66% of patients lost household income, and household income was reduced by 38%. To help cover the costs, 38% of patients sold some type of property, while 7% leased out property and 41% took out loans, any of which could jeopardize their future financial situation even further.

CONCLUSION: Despite services being officially free of charge, most patients incurred catastrophic costs and suffered significant income loss as a result of obtaining diagnosis and treatment for MDR-TB.
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Keywords: MDR-TB; TB; catastrophic costs; patient costs

Document Type: Research Article

Affiliations: 1: Management Sciences for Health, Medford, Massachusetts, Boston University School of Public Health, Boston, Massachusetts, USA 2: Hamlin Fistula Ethiopia, Addis Ababa 3: St Peter's TB Specialized Hospital, Addis Ababa 4: All Africa Leprosy, Tuberculosis and Rehabilitation Training Centre Hospital, Addis Ababa 5: University of Gonder Hospital, Gonder, Ethiopia

Publication date: 01 August 2018

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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