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Peer reviewedOpen accessTuberculosis

Costs incurred by patients with drug-susceptible pulmonary tuberculosis in semi-urban and rural settings of Western India

Infectious Diseases of Poverty·

Mihir P. Rupani, Adithya Cattamanchi, Priya B. Shete, William M. Vollmer, Sanjib Basu, Jigna D. Dave

DOI
10.1186/s40249-020-00760-w
PMID
33076969
PMCID
PMC7574230
OpenAlex
W3092870727
Study type
Cross-sectional study
Publisher
Springer Science and Business Media LLC
Article type
journal-article
Integrity
current

Why this research matters now

While treatment completion rates were high and patient costs were relatively low, negative financial consequences—including catastrophic costs, borrowing, and job loss—persisted even in this low-cost setting, indicating potential benefit from universal cash transfer programs.

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Structured evidence summary

Research question

The study estimated direct and indirect costs incurred by patients with drug-susceptible pulmonary tuberculosis in the Bhavnagar region of Gujarat state, India, using an adapted WHO costing tool.

Study design

A descriptive cross-sectional study was conducted among adults being treated for drug-susceptible pulmonary TB who were notified in the public sector during January–June 2019.

Population and setting

The study included 458 patients across six urban and three rural blocks in the Bhavnagar region of Gujarat state, western India; 70% were male, 62% had no formal education, and 71% lived in urban areas.

Main findings

Median total TB-related costs were USD 8 (IQR 5–28), with indirect costs (primarily lost wages) contributing more than direct non-medical costs (primarily travel). Four percent of patients faced catastrophic costs (exceeding 20% of annual household income), 11% borrowed money, and 7% lost employment. The median working days lost was 30. Treatment completion was 96%, and 88% of patients received cash transfers (median USD 43).

Public-health relevance

While treatment completion rates were high and patient costs were relatively low, negative financial consequences—including catastrophic costs, borrowing, and job loss—persisted even in this low-cost setting, indicating potential benefit from universal cash transfer programs.

Important limitations

This summary is limited to the supplied single-article abstract and metadata; the original paper is required for decision-grade interpretation. No explicit limitations were stated in the abstract.

GIDS interpretation

The study provides cost and financial hardship data relevant to understanding the economic burden of TB care in a high-burden setting. No surveillance signal or causal relationship to adverse events is addressed or supported by this evidence.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 8 auditable classifier relationships to diseases, places, topics, and study design.

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