ArticlePloS one2020
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 status.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Economic burden of multidrug-resistant tuberculosis on patients and households: a global systematic review and meta-analysis.Scientific reports · 2023Pooled it
- A systematic review and meta-analysis of the catastrophic costs incurred by tuberculosis patients.Scientific reports · 2022Pooled it
- Catastrophic costs and impoverishment among tuberculosis-affected households in Nepal: results from a national patient cost survey.Health policy and planning · 2026Article
- Tuberculosis epidemiology and programmatic progress in the WHO Western Pacific Region, 2010-2024: an analysis of surveillance data.Tropical medicine and health · 2026Article
- Assessment of financial protection mechanisms for tuberculosis services in seven priority countries of the Western Pacific Region: a cross-sectional mixed-methods study.Tropical medicine and health · 2026Article
- Towards universal social protection for people affected by tuberculosis in the Western Pacific Region: a social protection baseline assessment and policy entry points.Tropical medicine and health · 2026Review
- Programmatic approaches to screening for tuberculosis disease: a situational analysis of seven countries in the Western Pacific Region.Tropical medicine and health · 2025Article
- Effect of Poverty and Rural Settings on Catastrophic Expenditure in Multi-Drug-Resistant Tuberculosis: An Exploratory Study using Propensity Score Matching.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine · 2025Article
- Economic Burden of Tuberculosis in Iran: A Nationwide Analysis by Drug Resistance and Cost Components.Journal of research in health sciences · 2025Article
- Impact of Nutritional Counselling and Support on Body Mass Index Recovery and Treatment Outcomes Among Tuberculosis Patients in the Lao People's Democratic Republic.Tropical medicine and infectious disease · 2025Article
- Households of tuberculosis (TB) patients face high TB-related costs in Somalia.BMC global and public health · 2025Article
- Economic costing methodologies for drug-resistant bacterial infections in humans in low-and middle-income countries: a systematic review.Health economics review · 2025Review
- Does nutritional support contribute to mitigating the financial burden faced by TB-affected households?IJTLD open · 2025Article
- The prevalence of undernutrition and associated risk factors in people with tuberculosis in Lao People's Democratic Republic.PloS one · 2025Article
- The catastrophic cost of TB care: Understanding costs incurred by individuals undergoing TB care in low-, middle-, and high-income settings - A systematic review.PLOS global public health · 2025Article
- Catastrophic costs for tuberculosis patients in India: Impact of methodological choices.PLOS global public health · 2024Article
- Article
- Determinants of catastrophic costs among households affected by multi-drug resistant tuberculosis in Ho Chi Minh City, Viet Nam: a prospective cohort study.BMC public health · 2023Article
- Scoring tools to identify TB patients facing catastrophic costs in the Philippines.Public health action · 2023Article
- Post-TB health and wellbeing.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2023Article
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Authors and funding
13 authors at 5 institutions in 7 countries.
Funding
Abstract
backgroundTuberculosis (TB) patients incur large costs for care seeking, diagnosis, and treatment. To understand the magnitude of this financial burden and its main cost drivers, the Lao People's Democratic Republic (PDR) National TB Programme carried out the first national TB patient cost survey in 2018-2019.
methodA facility-based cross-sectional survey was conducted based on a nationally representative sample of TB patients from public health facilities across 12 provinces. A total of 848 TB patients including 30 drug resistant (DR)-TB and 123 TB-HIV coinfected patients were interviewed using a standardised questionnaire developed by the World Health Organization. Information on direct medical, direct non-medical and indirect costs, as well as coping mechanisms was collected. We estimated the percentage of TB-affected households facing catastrophic costs, which was defined as total TB-related costs accounting for more than 20% of annual household income.
resultThe median total cost of TB care was US$ 755 (Interquartile range 351-1,454). The costs were driven by direct non-medical costs (46.6%) and income loss (37.6%). Nutritional supplements accounted for 74.7% of direct non-medical costs. Half of the patients used savings, borrowed money or sold household assets to cope with TB. The proportion of unemployment more than doubled from 16.8% to 35.4% during the TB episode, especially among those working in the informal sector. Of all participants, 62.6% of TB-affected households faced catastrophic costs. This proportion was higher among households with DR-TB (86.7%) and TB-HIV coinfected patients (81.1%).
conclusionIn Lao PDR, TB patients and their households faced a substantial financial burden due to TB, despite the availability of free TB services in public health facilities. As direct non-medical and indirect costs were major cost drivers, providing free TB services is not enough to ease this financial burden. Expansion of existing social protection schemes to accommodate the needs of TB patients is necessary.
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