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The economic burden of TB faced by patients and affected families in Papua New Guinea

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BACKGROUND The costs associated with TB disease can be catastrophic for patients, affecting health and socioeconomic outcomes. Papua New Guinea (PNG) is a high TB burden country and the costs associated with TB are unknown.

METHODS We undertook a national survey of TB patients to determine the magnitude of costs associated with TB in PNG, the proportion of households with catastrophic costs and cost drivers. We used a cluster sampling approach and recruited TB patients from health facilities. Descriptive statistics were used to analyse the costs and cost drivers and multivariate logistic regression to determine factors associated with catastrophic costs.

RESULTS We interviewed 1,000 TB patients; 19 (1.9%) of them had multidrug-resistant TB (MDR-TB). Costs due to TB were attributable to income loss (64.4%), non-medical (29.9%) and medical (5.7%) expenses. Catastrophic costs were experienced by 33.9% (95% CI 31.0–36.9) of households and were associated with MDR-TB (aOR 4.47, 95% CI 1.21–16.50), hospitalization (aOR 3.94, 95% CI 2.69–5.77), being in the poorest (aOR 3.52, 95% CI 2.43–5.10) or middle wealth tertiles (aOR 1.51, 95% CI 1.03–2.21) or being employed (aOR 2.02, 95% CI 1.43–2.89).

CONCLUSION The costs due to TB disease were catastrophic for one third of TB-affected households in PNG. Current support measures could be continued, while new cost mitigation interventions may be considered where needed.

Keywords: costs; economic burden; tuberculosis

Document Type: Research Article

Affiliations: 1: National TB Control Programme, National Department of Health, Port Moresby, Papua New Guinea 2: The Karolinska Institutet, Stockholm, Sweden, Australian National University, Canberra ACT, Australia, Global TB Programme, World Health Organization (WHO), Geneva, Switzerland 3: WHO Country Office, Kathmandu, Nepal 4: WHO Regional Office for the Western Pacific, Manila, The Philippines 5: WHO Papua New Guinea Country Office, Port Moresby, Papua New Guinea 6: Global TB Programme, World Health Organization (WHO), Geneva, Switzerland 7: United States Centers for Disease Control and Prevention, Atlanta, GA, USA

Publication date: October 1, 2022

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