abstract: 'Background: Tuberculosis (TB) is a disease that disproportionately

  affects the poor. The World Health Organization lists economic factors

  as one of main barriers to tuberculosis management. Aims: This study

  aimed to estimate the household total catastrophic cost of TB and its

  determinants among newly diag-nosed Egyptian tuberculous patients.

  Methods: This was a cohort prospective study covering 257 TB patients

  registered in 2019. The patients were followed up bi-monthly until the

  end of the treatment regimen (4 visits). A standardized questionnaire

  published by the poverty sub-working group of the Stop TB Partnership

  was used after minor modification. The following costs were measured:

  pre-diagnosis, direct and indirect, guardian and coping, as well as

  annual household income. Catastrophic cost (direct plus indirect) was

  considered if the total cost of TB treatment exceeded 20\% of the

  household''s annual income. Sensitivity analyses were conducted using

  different thresholds. Results: The incidence of household total

  catastrophic cost was 24.1\%. The mean total cost of TB treatment was

  US\$ 198. Over 50\% of the total direct cost was incurred during the

  pre-diagnosis period. After adjustment for other determinant variables

  using multivariable logistic regression, we found that age < 30 years,

  living in a house with crowding index > 2, poverty and coping were more

  likely to cause higher total catastrophic cost. Conclusions:

  Catastrophic cost was experienced by 1 out of every 4 new TB patients.

  As the main cost drivers were pover-ty and coping, the Ministry of

  Health and Population should be collaborated with Ministry of Finance

  and NGOs to put a plan of social protection system for poor families

  with TB patients.'
affiliation: 'Gadallah, M (Corresponding Author), Ain Shams Univ, Dept Community Med,
  Fac Med, Cairo, Egypt.

  Gadallah, Mohsen; Rady, Mervat, Ain Shams Univ, Dept Community Med, Fac Med, Cairo,
  Egypt.

  Amin, Wagdy, Minist Hlth \& Populat, Chest Dept, Cairo, Egypt.'
author: Gadallah, Mohsen and Amin, Wagdy and Rady, Mervat
author-email: mohsengadallah@gmail.com
author_list:
- family: Gadallah
  given: Mohsen
- family: Amin
  given: Wagdy
- family: Rady
  given: Mervat
da: '2023-09-28'
doi: 10.26719/emhj.22.049
eissn: 1687-1634
files: []
issn: 1020-3397
journal: EASTERN MEDITERRANEAN HEALTH JOURNAL
keywords: catastrophic cost; tuberculosis; economic burden; cohort study; Egypt
keywords-plus: ECONOMIC BURDEN; DETERMINANTS; COUNTRIES; ILLNESS; CARE
language: English
month: JUL
number: '7'
number-of-cited-references: '24'
pages: 489-497
papis_id: ade1aa6731344d9502fadf88fba99509
ref: Gadallah2022householdcatastrophi
times-cited: '1'
title: 'Household catastrophic total cost due to tuberculosis in Egypt: incidence,
  cost drivers and policy implication'
type: article
unique-id: WOS:000835888900004
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '28'
web-of-science-categories: 'Health Care Sciences \& Services; Health Policy \& Services;
  Public,

  Environmental \& Occupational Health'
year: '2022'