Comparing catastrophic costs: Active vs. Passive tuberculosis case finding in urban Vietnam

Comparing catastrophic costs: Active vs. Passive tuberculosis case finding in urban Vietnam

Active case finding (ACF) is a strategy that aims to identify people with tuberculosis (TB) earlier in their disease. This outreach approach may lead to a reduction in catastrophic cost incurrence (costs exceeding 20% of annual household income), a main target of WHO's End TB Strategy. Our stud...

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Published in:Tropical medicine and infectious disease Vol. 8; no. 9; pp. 1 - 12
Main Authors: Dinh, Luong V., Wiemers, Anja M. C., Forse, Rachel J., Phan, Yen T. H., Codlin, Andrew J., Annerstedt, Kristi Sidney, Dong, Thuy T. T., Nguyen, Lan, Pham, Thuong H., Nguyen, Lan H., Dang, Ha M. T., Tuan, Mac H., Le, Phuc Thanh, Lonnroth, Knut, Creswell, Jacob, Khan, Amera, Kirubi, Beatrice, Nguyen, Hoa B., Nguyen, Nhung V., Vo, Luan N. Q.
Format: Journal Article
Language:English
Published: Basel, Switzerland MDPI 2023
MDPI AG
Subjects:
active case finding
catastrophic cost
Cost effectiveness
Costs
COVID-19
Data collection
Disease transmission
Evaluation
Family income
Health care expenditures
Households
Interviews
Medicin och hälsovetenskap
out of pocket
Patients
Personal income
Poverty
Prevention
Regression analysis
social protection
Treatment
Tuberculosis
Vietnam
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Summary:Active case finding (ACF) is a strategy that aims to identify people with tuberculosis (TB) earlier in their disease. This outreach approach may lead to a reduction in catastrophic cost incurrence (costs exceeding 20% of annual household income), a main target of WHO's End TB Strategy. Our study assessed the socio-economic impact of ACF by comparing patient costs in actively and passively detected people with TB. Longitudinal patient cost surveys were prospectively fielded for people with drug-sensitive pulmonary TB, with 105 detected through ACF and 107 passively detected. Data were collected in four Vietnamese cities between October 2020 and March 2022. ACF reduced pre-treatment (USD 10 vs. 101, 'p' < 0.001) and treatment costs (USD 888 vs. 1213, 'p' < 0.001) in TB-affected individuals. Furthermore, it reduced the occurrence of job loss (15.2% vs. 35.5%, 'p' = 0.001) and use of coping strategies (28.6% vs. 45.7%, 'p' = 0.004). However, catastrophic cost incurrence was high at 52.8% and did not differ between cohorts. ACF did not significantly decrease indirect costs, the largest contributor to catastrophic costs. ACF reduces costs but cannot sufficiently reduce the risk of catastrophic costs. As income loss is the largest driver of costs during TB treatment, social protection schemes need to be expanded.
Bibliography:Tropical Medicine and Infectious Disease, Vol. 8, No. 9, Sep 2023, 1-12
Informit, Melbourne (Vic)
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:2414-6366
2414-6366
DOI:10.3390/tropicalmed8090423