Custos catastróficos em pacientes com tuberculose no Brasil: estudo em cinco capitais

Guidoni, Laura; Negri, Leticya dos Santos Almeida; Carlesso, Geisa Fregona; Zandonade, Eliana; Maciel, Ethel Leonor Nóia

doi:10.1590/2177-9465-ean-2020-0546

Cited by 7 publications

(13 citation statements)

References 17 publications

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“…In our study we found that 44.4% DS-TB-affected households and 78.5% DR-TB-affected households experienced catastrophic costs due to the disease. Our result for DR-TB patients and their households is consistent with the findings of the Rio de Janeiro’s study where 68% of DR-TB patients experienced catastrophic costs due to TB [ 24 ]. Based on these results social protection measures could be specifically evaluated for DR-TB patients.…”

Section: Discussionsupporting

confidence: 91%

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The economic burden of households affected by tuberculosis in Brazil: First national survey results, 2019-2021

Noia Maciel,

Negri,

Guidoni

et al. 2023

PLoS ONE

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Background One of the three main targets of the World Health Organization (WHO) End TB Strategy (2015-2035) is that no tuberculosis (TB) patients or their households face catastrophic costs (defined as exceeding 20% of the annual household income) because of the disease. Our study seeks to determine, as a baseline, the magnitude and main drivers of the costs associated with TB disease for patients and their households and to monitor the proportion of households experiencing catastrophic costs in Brazil. Methods A national cross-sectional cluster-based survey was conducted in Brazil in 2019-2021 following WHO methodology. TB patients of all ages and types of TB were eligible for the survey. Adult TB patients and guardians of minors (<18 years old) were interviewed once about costs, time loss, coping measures, income, household expenses, and asset ownership. Total costs, including indirect costs measured as reported household income change, were expressed as a percentage of annual household income. We used descriptive statistics to analyze the cost drivers and multivariate logistic regression to determine factors associated with catastrophic costs. Results We interviewed 603 patients, including 538 (89%) with drug-sensitive (DS) and 65 (11%) with drug-resistant (DR) TB. Of 603 affected households, 48.1% (95%CI: 43–53.2) experienced costs above 20% of their annual household income during their TB episode. The proportion was 44.4% and 78.5% among patients with DS- and DR-TB, respectively. On average, patients incurred costs of US$1573 (95%CI: 1361.8–1785.0) per TB episode, including pre-diagnosis and post-diagnosis expenses. Key cost drivers were post-diagnosis nutritional supplements (US$317.6, 95%CI: 232.7–402.6) followed by medical costs (US$85.5, 95%CI: 54.3–116.5) and costs of travel for clinic visits during treatment (US$79.2, 95%CI: 61.9–96.5). In multivariate analysis, predictors of catastrophic costs included positive HIV status (aOR = 3.0, 95%CI:1.1–8.6) and self-employment (aOR = 2.7, 95%CI:1.1–6.5); high education was a protective factor (aOR = 0.1, 95%CI:0.0–0.9). Conclusions Although the services offered to patients with TB are free of charge in the Brazilian public health sector, the availability of free diagnosis and treatment services does not alleviate patients’ financial burden related to accessing TB care. The study allowed us to identify the costs incurred by patients and suggest actions to mitigate their suffering. In addition, this study established a baseline for monitoring catastrophic costs and fostering a national policy to reduce the costs to patients for TB care in Brazil.

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Section: Discussionsupporting

confidence: 91%

“…A study by Guidoni L.M. et al, conducted in five large cities in Brazil, found that on average income of participants declined by 11% during the TB episode and 41% faced direct and indirect costs that were higher than 20% of self-reported household income prior to TB [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

The economic burden of households affected by tuberculosis in Brazil: First national survey results, 2019-2021

Noia Maciel,

Negri,

Guidoni

et al. 2023

PLoS ONE

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“…Tal situação pode ocasionar o rompimento de relações, contribuindo para a fragilidade da rede. Os enfermeiros e demais profissionais da saúde devem estar sempre atentos à ineficácia da rede social, que pode levar ao abandono do tratamento, agravamento da doença e manutenção da cadeia de transmissão, além do aumento de custos catastróficos durante o período de tratamento da TB 12,[20][21] .…”

Section: Discussionunclassified

Mapa Da Rede Social: Tecnologia Para Abordagem Da Pessoa Com Tuberculose Pulmonar

Ferreira

Nascimento

Sodré

et al. 2022

Texto contexto - enferm.

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RESUMO Objetivo: compreender o mapa da rede social primária como uma tecnologia de abordagem à pessoa com tuberculose pulmonar. Método estudo qualitativo, fundamentado no referencial teórico-metodológico de Rede Social, realizado com 32 pessoas com diagnóstico de tuberculose pulmonar, em Unidades Básicas de Saúde do Rio de Janeiro, Brasil, de janeiro a fevereiro de 2020. Os dados foram coletados em uma entrevista semiestruturada, por meio de um roteiro para a caracterização dos participantes e elaboração do mapa da rede social. Utilizou-se a técnica da análise de conteúdo. Resultados na representação dos mapas, observou-se a presença de vínculo forte dos participantes com os membros da sua rede primária, composta por familiares, amigos vizinhos e colegas. Nessa vivência interpessoal, os apoios recebidos foram especialmente o emocional e o material. Conclusão a utilização do mapa da rede social como uma tecnologia de abordagem mostrou-se inovadora e original no que tange à assistência da pessoa com tuberculose pulmonar, permitindo ao profissional de saúde exercer sua prática assistencial de forma integrada com membros dessa rede, especialmente aqueles que poderão auxiliar no cuidado, prevenção do abandono e tratamento da doença.

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“…Such a situation can cause rupture of relationships, contributing to fragility of the network. Nurses and other health professionals should always be aware of the ineffectiveness of a social network, which can lead to treatment abandonment, disease worsening and maintenance of the transmission chain, in addition to increased catastrophic costs during the TB treatment period 12,[20][21] .…”

Section: /11mentioning

confidence: 99%

Social Network Map: A Technology for the Approach to People With Pulmonary Tuberculosis

Ferreira

Nascimento

Sodré

et al. 2022

Texto contexto - enferm.

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Objective to understand the primary social network map as a technology for the approach to people with pulmonary tuberculosis. Method a qualitative study, grounded on the Social Network theoretical-methodological framework and carried out from January to February 2020 with 32 individuals diagnosed with pulmonary tuberculosis at Basic Health Units in Rio de Janeiro, Brazil. The data were collected in semi-structured interviews by means of a script to characterize the participants and prepare the social network map. The content analysis technique was used. Results in the representation of the maps there was presence of a strong connection between the participants and the members of their primary network, comprised by family members, close friends and colleagues. In this interpersonal experience, the types of support received were especially emotional and/or material. Conclusion using a social network map as an approach technology proved to be innovative and original with regard to the care provided to people with pulmonary tuberculosis, allowing health professionals to carry out their care practice in an integrated way with members of this network, especially those who may assist in care, prevention of abandonment and treatment of the disease.

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Custos catastróficos em pacientes com tuberculose no Brasil: estudo em cinco capitais

Cited by 7 publications

References 17 publications

The economic burden of households affected by tuberculosis in Brazil: First national survey results, 2019-2021

The economic burden of households affected by tuberculosis in Brazil: First national survey results, 2019-2021

Mapa Da Rede Social: Tecnologia Para Abordagem Da Pessoa Com Tuberculose Pulmonar

Social Network Map: A Technology for the Approach to People With Pulmonary Tuberculosis

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