Research article

Determinants of tuberculosis treatment support costs to the treatment supporters in rural Ghana

  • Received: 01 November 2022 Revised: 30 January 2023 Accepted: 08 February 2023 Published: 21 February 2023
  • Background 

    The Ghana Health Service has been implementing the Directly Observed Therapy Short Course (DOTS) strategy for decades now, to cure and reduce the transmission of tuberculosis. DOTS strategy requires TB patients and their treatment supporters to make multiple clinic visits in the course of treatment, and this may place financial burden on treatment supporters with low socio-economic status. However, the determinants of tuberculosis treatment support costs to treatment supporters are unknown in Ghana.

    Objectives 

    This study determined the costs associated with treatment support to the treatment supporters in Bono Region, Ghana.

    Methods 

    In a cross-sectional study using cost-of-illness approach, 385 treatment supporters were selected and interviewed. A validated questionnaire for the direct and indirect costs incurred was used. Descriptive statistics and bivariate techniques were used for data analysis.

    Results 

    Averagely, each treatment supporter spent GHS 122.4 (US$ 21.1) on treatment support activities per month, which is about 19% of their monthly income. The findings also revealed that highest level of education, household size, monthly income and district of residence were significant predictors of the direct costs. On the other hand, gender of the respondents, highest level of education, ethnicity, household size, income level and relationship with patient were some of the factors that significantly influenced the indirect costs. The significance levels were set at a 95% confidence interval and p < 0.05.

    Conclusion 

    The study concludes that the estimated cost associated with assisting tuberculosis patients with treatment is significant to treatment supporters. If these costs are not mitigated, they have the tendency of affecting the socio-economic status and welfare of individuals assisting tuberculosis patients with treatment.

    Citation: Robert Bagngmen Bio, Patricia Akweongo, Augustine Adomah-Afari, Augustina Koduah. Determinants of tuberculosis treatment support costs to the treatment supporters in rural Ghana[J]. AIMS Public Health, 2023, 10(1): 78-93. doi: 10.3934/publichealth.2023007

    Related Papers:

  • Background 

    The Ghana Health Service has been implementing the Directly Observed Therapy Short Course (DOTS) strategy for decades now, to cure and reduce the transmission of tuberculosis. DOTS strategy requires TB patients and their treatment supporters to make multiple clinic visits in the course of treatment, and this may place financial burden on treatment supporters with low socio-economic status. However, the determinants of tuberculosis treatment support costs to treatment supporters are unknown in Ghana.

    Objectives 

    This study determined the costs associated with treatment support to the treatment supporters in Bono Region, Ghana.

    Methods 

    In a cross-sectional study using cost-of-illness approach, 385 treatment supporters were selected and interviewed. A validated questionnaire for the direct and indirect costs incurred was used. Descriptive statistics and bivariate techniques were used for data analysis.

    Results 

    Averagely, each treatment supporter spent GHS 122.4 (US$ 21.1) on treatment support activities per month, which is about 19% of their monthly income. The findings also revealed that highest level of education, household size, monthly income and district of residence were significant predictors of the direct costs. On the other hand, gender of the respondents, highest level of education, ethnicity, household size, income level and relationship with patient were some of the factors that significantly influenced the indirect costs. The significance levels were set at a 95% confidence interval and p < 0.05.

    Conclusion 

    The study concludes that the estimated cost associated with assisting tuberculosis patients with treatment is significant to treatment supporters. If these costs are not mitigated, they have the tendency of affecting the socio-economic status and welfare of individuals assisting tuberculosis patients with treatment.



    加载中

    Acknowledgments



    The authors of this study express their unconditional gratitude to the tuberculosis treatment supporters and also the faculty members' School of Public Health, University of Ghana, for their input in fine-tuning the study protocol.

    Conflict of interest



    The authors declare no conflict of interest.

    [1] Tanimura T, Jaramillo E, Weil D, et al. (2014) Financial burden for tuberculosis patients in low- And middle-income countries: A systematic review. Eur Respir J 43: 1763-1775. https://doi.org/10.1183/09031936.00193413
    [2] Aryee G, Kwarteng E, Essuman R, et al. (2018) Estimating the incidence of tuberculosis cases reported at a tertiary hospital in Ghana: A time series model approach. BMC Public Health 18: 1-8. https://doi.org/10.1186/s12889-018-6221-z
    [3] Osei E, Oppong S, Adanfo D, et al. (2019) Reflecting on tuberculosis case notification and treatment outcomes in the Volta region of Ghana: A retrospective pool analysis of a multicentre cohort from 2013 to 2017. Glob Heal Res Policy 4: 37. https://doi.org/10.1186/s41256-019-0128-9
    [4] Hill PC, Whalen CC (2014) Non-clinical factors associated with TB: Important for DOTS impact evaluation and disease elimination. Trans R Soc Trop Med Hyg 108: 523-525. https://doi.org/10.1093/trstmh/tru114
    [5] Soomro M, Qadeer E, Amir Khan M, et al. (2012) Treatment supporters and their impact on treatment outcomes in routine tuberculosis program conditions in rawalpindi district, pakistan. Tanaffos 11: 15-22.
    [6] Izudi J, Tamwesigire IK, Bajunirwe F (2020) Treatment supporters and level of health facility influence completion of sputum smear monitoring among tuberculosis patients in rural Uganda: A mixed-methods study. Int J Infect Dis 91: 149-155. https://doi.org/10.1016/j.ijid.2019.12.003
    [7] Lönroth K, Raviglione M (2015) The WHO's new end tb strategy in the post-2015 era of the sustainable development goals. Trans R Soc Trop Med Hyg 110: 148-150. https://doi.org/10.1093/trstmh/trv108
    [8] Arnold M, Beran D, Haghparast-Bidgoli H, et al. (2016) Coping with the economic burden of Diabetes, TB and co-prevalence: Evidence from Bishkek, Kyrgyzstan. BMC Health Serv Res 16: 118. https://doi.org/10.1186/s12913-016-1369-7
    [9] Atif M, Sulaiman SAS, Shafie AA, et al. (2014) Resource utilization pattern and cost of tuberculosis treatment from the provider and patient perspectives in the state of Penang, Malaysia. BMC Health Serv Res 14: 353. https://doi.org/10.1186/1472-6963-14-353
    [10] Laokri S, Dramaix-Wilmet M, Kassa F, et al. (2014) Assessing the economic burden of illness for tuberculosis patients in Benin: determinants and consequences of catastrophic health expenditures and inequities. Trop Med Int Heal 19: 1249-1258. https://doi.org/10.1111/tmi.12365
    [11] GHS.Ghana Health Service Regional Health Directorate Brong Ahafo Region 2018 Annual report. Ghana Heal Serv (2018) 126.
    [12] Bonsu F, Pedrazzoli D, Siroka A, et al. The 2016 patient cost survey in Ghana: results and implications (2018). Avaliable from: https://cdn.who.int/media/docs/default-source/hq-tuberculosis/global-task-force-on-tb-impact-measurement/meetings/2018-05/tf7_p21_ghana_patient_cost_survey.pdf.
    [13] Koopmanschap MA, Van Exel NJA, Van Den Berg B, et al. (2008) An overview of methods and applications to value informal care in economic evaluations of healthcare. Pharmacoeconomics 26: 269-280. https://doi.org/10.2165/00019053-200826040-00001
    [14] Ministry of Employment and Labour RelationsRepublic of Ghana: Ministry of Employment and Labour Relations, Medium Term Expenditure Framework (MTEF) (2019). Avaliable from: https://www.ghana.gov.gh/ministries/89eeb1f13e/.
    [15] Addo R, Agyemang SA, Tozan Y, et al. (2018) Economic burden of caregiving for persons with severe mental illness in sub-Saharan Africa: A systematic review. PLoS One 13: e0199830. https://doi.org/10.1371/journal.pone.0199830
    [16] Needham DM, Godfrey-Faussett P, Foster SD (1998) Barriers to tuberculosis control in urban Zambia: the economic impact and burden on patients prior to diagnosis. Int J Tuberc Lung Dis 2: 811-817.
    [17] Assebe LF, Negussie EK, Jbaily A, et al. (2020) Financial burden of HIV and TB among patients in Ethiopia: a cross-sectional survey. BMJ Open 10: e036892. https://doi.org/10.1136/bmjopen-2020-036892
    [18] Wyss K, Kilima P, Lorenz N (2001) Costs of tuberculosis for households and health care providers in Dar es Salaam, Tanzania. Trop Med Int Health 6: 60-68. https://doi.org/10.1046/j.1365-3156.2001.00677.x
    [19] Elamin EI, Ibrahim MIM, Sulaiman SAS, et al. (2008) Cost of illness of tuberculosis in Penang, Malaysia. Pharm World Sci 30: 281-286. https://doi.org/10.1007/s11096-007-9185-0
    [20] Fuady A, Houweling TAJ, Mansyur M, et al. (2018) Catastrophic total costs in tuberculosis-affected households and their determinants since Indonesia's implementation of universal health coverage. Infect Dis Poverty 7: 3. https://doi.org/10.1186/s40249-017-0382-3
    [21] Getahun B, Wubie M, Dejenu G, et al. (2016) Tuberculosis care strategies and their economic consequences for patients: The missing link to end tuberculosis. Infect Dis Poverty 5: 93. https://doi.org/10.1186/s40249-016-0187-9
    [22] Foster N, Vassall A, Cleary S, et al. (2015) The economic burden of TB diagnosis and treatment in South Africa. Soc Sci Med 130: 42-50. https://doi.org/10.1016/j.socscimed.2015.01.046
    [23] Sajith M, Thomas A, Kothia JJ, et al. (2015) Cost of therapy incurred for tuberculosis patients receiving directly observed therapy (DOT). Int J Pharm Pharm Sci 7: 141-144.
    [24] Jackson S, Sleigh AC, Wang GJ, et al. (2006) Poverty and the economic effects of TB in rural China. Int J Tuberc Lung Dis 10: 1104-1110.
    [25] Asres A, Jerene D, Deressa W (2018) Pre- And post-diagnosis costs of tuberculosis to patients on Directly Observed Treatment Short course in districts of southwestern Ethiopia: A longitudinal study. J Heal Popul Nutr 37: 15. https://doi.org/10.1186/s41043-018-0146-0
    [26] Tarricone R (2006) Cost-of-illness analysis What room in health economics?. Health Policy 77: 51-63. https://doi.org/10.1016/j.healthpol.2005.07.016
    [27] Ukwaja KN, Alobu I, lgwenyi C, et al. (2013) The high cost of free tuberculosis services: patient and household costs associated with tuberculosis care in Ebonyi State, Nigeria. PLoS One 8: e73134. https://doi.org/10.1371/journal.pone.0073134
    [28] John KR, Daley P, Kincler N, et al. (2009) Costs incurred by patients with pulmonary tuberculosis in rural India. Int J Tuberc Lung Dis 13: 1281-1287.
    [29] Russell S (2004) The economic burden of illness for households in developing countries: a review of studies focusing on malaria, tuberculosis, and human immunodeficiency virus/acquired immunodeficiency syndrome. Am J Trop Med Hyg 71: 147-155. https://doi.org/10.4269/ajtmh.2004.71.147
    [30] Umar NA, Fordham R, Abubakar I, et al. (2012) The indirect cost due to pulmonary Tuberculosis in patients receiving treatment in Bauchi State-Nigeria. Cost Eff Resour Alloc 10: 6. https://doi.org/10.1186/1478-7547-10-6
  • Reader Comments
  • © 2023 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Metrics

Article views(1751) PDF downloads(115) Cited by(1)

Article outline

Figures and Tables

Tables(6)

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog