How to reduce household costs for people with tuberculosis: a longitudinal costing survey in Nepal

The aim of this study was to compare costs and socio-economic impact of tuberculosis (TB) for
patients diagnosed through active (ACF) and passive case finding (PCF) in Nepal. A longitudinal
costing survey was conducted in four districts of Nepal from April 2018 to October 2019. Costs
were collected using the WHO TB Patient Costs Survey at three time points: intensive phase of
treatment, continuation phase of treatment and at treatment completion. Direct and indirect costs
and socio-economic impact (poverty headcount, employment status and coping strategies) were
evaluated throughout the treatment. Prevalence of catastrophic costs was estimated using the
WHO threshold. Logistic regression and generalized estimating equation were used to evaluate
risk of incurring high costs, catastrophic costs and socio-economic impact of TB over time.

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