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Mitigating Financial Burden of Tuberculosis through Active Case Finding Targeting Household and Neighbourhood Contacts in Cambodia

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  • Fukushi Morishita
  • Rajendra-Prasad Yadav
  • Mao Tan Eang
  • Saly Saint
  • Nobuyuki Nishikiori

Abstract

Background: Despite free TB services available in public health facilities, TB patients often face severe financial burden due to TB. WHO set a new global target that no TB-affected families experience catastrophic costs due to TB. To monitor the progress and strategize the optimal approach to achieve the target, there is a great need to assess baseline cost data, explore potential proxy indicators for catastrophic costs, and understand what intervention mitigates financial burden. In Cambodia, nationwide active case finding (ACF) targeting household and neighbourhood contacts was implemented alongside routine passive case finding (PCF). We analyzed household cost data from ACF and PCF to determine the financial benefit of ACF, update the baseline cost data, and explore whether any dissaving patterns can be a proxy for catastrophic costs in Cambodia. Methods: In this cross-sectional comparative study, structured interviews were carried out with 108 ACF patients and 100 PCF patients. Direct and indirect costs, costs before and during treatment, costs as percentage of annual household income and dissaving patterns were compared between the two groups. Results: The median total costs were lower by 17% in ACF than in PCF ($240.7 [IQR 65.5–594.6] vs $290.5 [IQR 113.6–813.4], p = 0.104). The median costs before treatment were significantly lower in ACF than in PCF ($5.1 [IQR 1.5–25.8] vs $22.4 [IQR 4.4–70.8], p

Suggested Citation

  • Fukushi Morishita & Rajendra-Prasad Yadav & Mao Tan Eang & Saly Saint & Nobuyuki Nishikiori, 2016. "Mitigating Financial Burden of Tuberculosis through Active Case Finding Targeting Household and Neighbourhood Contacts in Cambodia," PLOS ONE, Public Library of Science, vol. 11(9), pages 1-22, September.
    • Handle: RePEc:plo:pone00:0162796
    DOI: 10.1371/journal.pone.0162796
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    References listed on IDEAS

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    1. Kolesar, Robert John & Pheakdey, Sambo & Jacobs, Bart & Phay, Sokchegn, 2021. "Decision time: Cost estimations and policy implications to advance Universal Health Coverage in Cambodia," Journal of Policy Modeling, Elsevier, vol. 43(1), pages 127-145.
    2. Olivia Biermann & Phuong Bich Tran & Kerri Viney & Maxine Caws & Knut Lönnroth & Kristi Sidney Annerstedt, 2020. "Active case-finding policy development, implementation and scale-up in high-burden countries: A mixed-methods survey with National Tuberculosis Programme managers and document review," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-17, October.
    3. Phonenaly Chittamany & Takuya Yamanaka & Sakhone Suthepmany & Thepphouthone Sorsavanh & Phitsada Siphanthong & Jacques Sebert & Kerri Viney & Thipphasone Vixaysouk & Moeko Nagai & Vilath Seevisay & Ki, 2020. "First national tuberculosis patient cost survey in Lao People’s Democratic Republic: Assessment of the financial burden faced by TB-affected households and the comparisons by drug-resistance and HIV s," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-21, November.

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