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Comparing Catastrophic Costs: Active vs. Passive Tuberculosis Case Finding in Urban Vietnam

Active case finding (ACF) is a strategy that aims to identify people with tuberculosis (TB) earlier in their disease. This outreach approach may lead to a reduction in catastrophic cost incurrence (costs exceeding 20% of annual household income), a main target of WHO’s End TB Strategy. Our study ass...

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Autores principales: Dinh, Luong V., Wiemers, Anja M. C., Forse, Rachel J., Phan, Yen T. H., Codlin, Andrew J., Annerstedt, Kristi Sidney, Dong, Thuy T. T., Nguyen, Lan, Pham, Thuong H., Nguyen, Lan H., Dang, Ha M. T., Tuan, Mac H., Le, Phuc Thanh, Lonnroth, Knut, Creswell, Jacob, Khan, Amera, Kirubi, Beatrice, Nguyen, Hoa B., Nguyen, Nhung V., Vo, Luan N. Q.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10535862/
https://www.ncbi.nlm.nih.gov/pubmed/37755885
http://dx.doi.org/10.3390/tropicalmed8090423
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author Dinh, Luong V.
Wiemers, Anja M. C.
Forse, Rachel J.
Phan, Yen T. H.
Codlin, Andrew J.
Annerstedt, Kristi Sidney
Dong, Thuy T. T.
Nguyen, Lan
Pham, Thuong H.
Nguyen, Lan H.
Dang, Ha M. T.
Tuan, Mac H.
Le, Phuc Thanh
Lonnroth, Knut
Creswell, Jacob
Khan, Amera
Kirubi, Beatrice
Nguyen, Hoa B.
Nguyen, Nhung V.
Vo, Luan N. Q.
author_facet Dinh, Luong V.
Wiemers, Anja M. C.
Forse, Rachel J.
Phan, Yen T. H.
Codlin, Andrew J.
Annerstedt, Kristi Sidney
Dong, Thuy T. T.
Nguyen, Lan
Pham, Thuong H.
Nguyen, Lan H.
Dang, Ha M. T.
Tuan, Mac H.
Le, Phuc Thanh
Lonnroth, Knut
Creswell, Jacob
Khan, Amera
Kirubi, Beatrice
Nguyen, Hoa B.
Nguyen, Nhung V.
Vo, Luan N. Q.
author_sort Dinh, Luong V.
collection PubMed
description Active case finding (ACF) is a strategy that aims to identify people with tuberculosis (TB) earlier in their disease. This outreach approach may lead to a reduction in catastrophic cost incurrence (costs exceeding 20% of annual household income), a main target of WHO’s End TB Strategy. Our study assessed the socio-economic impact of ACF by comparing patient costs in actively and passively detected people with TB. Longitudinal patient cost surveys were prospectively fielded for people with drug-sensitive pulmonary TB, with 105 detected through ACF and 107 passively detected. Data were collected in four Vietnamese cities between October 2020 and March 2022. ACF reduced pre-treatment (USD 10 vs. 101, p < 0.001) and treatment costs (USD 888 vs. 1213, p < 0.001) in TB-affected individuals. Furthermore, it reduced the occurrence of job loss (15.2% vs. 35.5%, p = 0.001) and use of coping strategies (28.6% vs. 45.7%, p = 0.004). However, catastrophic cost incurrence was high at 52.8% and did not differ between cohorts. ACF did not significantly decrease indirect costs, the largest contributor to catastrophic costs. ACF reduces costs but cannot sufficiently reduce the risk of catastrophic costs. As income loss is the largest driver of costs during TB treatment, social protection schemes need to be expanded.
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spelling pubmed-105358622023-09-29 Comparing Catastrophic Costs: Active vs. Passive Tuberculosis Case Finding in Urban Vietnam Dinh, Luong V. Wiemers, Anja M. C. Forse, Rachel J. Phan, Yen T. H. Codlin, Andrew J. Annerstedt, Kristi Sidney Dong, Thuy T. T. Nguyen, Lan Pham, Thuong H. Nguyen, Lan H. Dang, Ha M. T. Tuan, Mac H. Le, Phuc Thanh Lonnroth, Knut Creswell, Jacob Khan, Amera Kirubi, Beatrice Nguyen, Hoa B. Nguyen, Nhung V. Vo, Luan N. Q. Trop Med Infect Dis Article Active case finding (ACF) is a strategy that aims to identify people with tuberculosis (TB) earlier in their disease. This outreach approach may lead to a reduction in catastrophic cost incurrence (costs exceeding 20% of annual household income), a main target of WHO’s End TB Strategy. Our study assessed the socio-economic impact of ACF by comparing patient costs in actively and passively detected people with TB. Longitudinal patient cost surveys were prospectively fielded for people with drug-sensitive pulmonary TB, with 105 detected through ACF and 107 passively detected. Data were collected in four Vietnamese cities between October 2020 and March 2022. ACF reduced pre-treatment (USD 10 vs. 101, p < 0.001) and treatment costs (USD 888 vs. 1213, p < 0.001) in TB-affected individuals. Furthermore, it reduced the occurrence of job loss (15.2% vs. 35.5%, p = 0.001) and use of coping strategies (28.6% vs. 45.7%, p = 0.004). However, catastrophic cost incurrence was high at 52.8% and did not differ between cohorts. ACF did not significantly decrease indirect costs, the largest contributor to catastrophic costs. ACF reduces costs but cannot sufficiently reduce the risk of catastrophic costs. As income loss is the largest driver of costs during TB treatment, social protection schemes need to be expanded. MDPI 2023-08-23 /pmc/articles/PMC10535862/ /pubmed/37755885 http://dx.doi.org/10.3390/tropicalmed8090423 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Dinh, Luong V.
Wiemers, Anja M. C.
Forse, Rachel J.
Phan, Yen T. H.
Codlin, Andrew J.
Annerstedt, Kristi Sidney
Dong, Thuy T. T.
Nguyen, Lan
Pham, Thuong H.
Nguyen, Lan H.
Dang, Ha M. T.
Tuan, Mac H.
Le, Phuc Thanh
Lonnroth, Knut
Creswell, Jacob
Khan, Amera
Kirubi, Beatrice
Nguyen, Hoa B.
Nguyen, Nhung V.
Vo, Luan N. Q.
Comparing Catastrophic Costs: Active vs. Passive Tuberculosis Case Finding in Urban Vietnam
title Comparing Catastrophic Costs: Active vs. Passive Tuberculosis Case Finding in Urban Vietnam
title_full Comparing Catastrophic Costs: Active vs. Passive Tuberculosis Case Finding in Urban Vietnam
title_fullStr Comparing Catastrophic Costs: Active vs. Passive Tuberculosis Case Finding in Urban Vietnam
title_full_unstemmed Comparing Catastrophic Costs: Active vs. Passive Tuberculosis Case Finding in Urban Vietnam
title_short Comparing Catastrophic Costs: Active vs. Passive Tuberculosis Case Finding in Urban Vietnam
title_sort comparing catastrophic costs: active vs. passive tuberculosis case finding in urban vietnam
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10535862/
https://www.ncbi.nlm.nih.gov/pubmed/37755885
http://dx.doi.org/10.3390/tropicalmed8090423
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