Making the most of poor diagnostics : increasing access to tuberculosis treatment through optimized smear microscopy services
Year: 2010
Type: other
Abstract: Background: The diagnosis of TB requires multiple visits. There is limited information on whether reducing the number of visits would make the process more accessible and result in signifi cant savings to the patients. Objective: To describe the direct costs incurred by patients with chronic cough consulting TB diagnostic centres. Method: Cross-sectional surveys of adults with cough >3 weeks duration were conducted using structured questionnaires in Yemen and Nepal to quantify their expenses. Results: 456 adults were interviewed. Most patients were accompanied and 20% were smear-positive. More patients in Nepal were male, resided in urban areas and were older than in Yemen (123/206 (60%), 152 (74%) and mean of 41 years compared to 120/250 (48%), 114 (36%) and 35 years, respectively). Most patients from rural areas stayed with relatives. Clinic fees represented the highest expenditure (median of Nepalese Rs 300 and Yemeni YER450, respectively), followed by food and transport. Patients from rural areas paid more than patients from urban areas. Clinic fees thus were the highest expenditure in both countries and rural patients paid more than urban patients in both settings. The expenses for diagnosis were equivalent to one week of the national income per capita. Conclusion: Patients incur considerable costs for diagnosis and clinic fees represent a substantial component of these costs. Patients requiring investigations for TB should be able to access diagnostic services free of charge.
Author: Andrew Ramsay
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2166982047