Samia Laokri|Michèle Dramaix?Wilmet|Ferdinand Kassa|S. Anagonou|Bruno Dujardin
Assessing the economic burden of illness for tuberculosis patients in Benin: determinants and consequences of catastrophic health expenditures and inequities
Université Libre de Bruxelles|Université Libre de Bruxelles|Progamme National Contre le Tuberculose|Progamme National Contre le Tuberculose|Université Libre de Bruxelles
abstract objectives inform policymaking measured risk causes consequences catastrophic expenditures tuberculosis investigated potential inequities methods august 2008 february 2009 crosssectional study conducted among 245 smearpositive pulmonary tuberculosis patients six health districts southern benin standardised survey questionnaire covered period time elapsing onset tuberculosis symptoms completion treatment total direct cost exceeding conventional 10 threshold annual income defined catastrophic used principal outcome multivariable logistic regression sensitivity analysis performed varying thresholds results pure gradient direct costs tuberculosis relation income observed incidence 781 intensity 148 catastrophic expenditure high varying thresholds insensitive intensity incurring catastrophic expenditure independently associated lower middleincome quintiles adjusted odd ratio aor 362 95 ci 1231063 aor 64 28146 adverse prediagnosis stage aor 54 22133 less education aor 411987 households incurred important days lost due tb indebtedness 371 dissaving 510 coping strategies 527 conclusions catastrophic direct costs substantial indirect coping costs may persist free tuberculosis diagnosis treatment strategy well inequities financial hardship