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Catastrophic total costs in tuberculosisaffected households and their determinants since Indonesia’s implementation of universal health coverage

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Infectious Diseases of Poverty 2018年第1期7卷 30-43页

作者： ahmad fuady Tanja A.J.Houweling Muchtaruddin Mansyur Jan Hendrik Richardus Department of Public Health Erasmus MCUniversity Medical Center RotterdamP.O.Box 20403000CA RotterdamThe Netherlands Department of Community Medicine Faculty of MedicineUniversitas IndonesiaJakartaIndonesia

Background:As well as imposing an economic burden on affected households,the high costs related to tuberculosis(TB)can create access and adherence *** highlights the particular urgency of achieving one of the End TB Strategy’s targets:that no TB-affected households have to face catastrophic costs by *** Indonesia,as elsewhere,there is also an emerging need to provide social protection by implementing universal health coverage(UHC).We therefore assessed the incidence of catastrophic total costs due to TB,and their determinants since the implementation of ***:We interviewed adult TB and multidrug-resistant TB(MDR-TB)patients in urban,suburban and rural areas of Indonesia who had been treated for at least one month or had finished treatment no more than one month *** the WHO recommendation,we assessed the incidence of catastrophic total costs due to *** also analyzed the sensitivity of incidence relative to several thresholds,and measured differences between poor and non-poor households in the incidence of catastrophic *** linear mixed-model analysis was used to identify determinants of the catastrophic total ***:We analyzed 282 TB and 64 MDR-TB *** TB-related services,the median(interquartile range)of total costs incurred by households was 133 USD(55-576);for MDR-TB-related services,it was 2804 USD(1008-4325).The incidence of catastrophic total costs in all TB-affected households was 36%(43%in poor households and 25%in non-poor households).For MDR-TB-affected households,the incidence was 83%(83%and 83%).In TB-affected households,the determinants of catastrophic total costs were poor households(adjusted odds ratio[aOR]=3.7,95%confidence interval[CI]:1.7-7.8);being a breadwinner(aOR=2.9,95%CI:1.3-6.6);job loss(aOR=21.2;95%CI:8.3-53.9);and previous TB treatment(aOR=2.9;95%CI:1.4-6.1).In MDR-TB-affected households,having an income-earning job before diagnosis was the only determinant of catastrophic to

关键词： Tuberculosis Catastrophic total cost Determinant Indonesia

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Interventions pathways to reduce tuberculosis-related stigma:a literature review and conceptual framework

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Infectious Diseases of Poverty 2022年第5期11卷 90-90页

作者： Charlotte Nuttall ahmad fuady Holly Nuttall Kritika Dixit Muchtaruddin Mansyur Tom Wingfeld Department of Clinical Infection Microbiology and ImmunologyUniversity of LiverpoolLiverpoolUK 不详

Background:Prevention of tuberculosis(TB)-related stigma is vital to achieving the World Health Organisation’s End TB Strategy target of eliminating ***,the process and impact evaluation of interventions to reduce TB-stigma are *** literature review aimed to examine the quality,design,implementation challenges,and successes of TB-stigma intervention studies and create a novel conceptual framework of pathways to TB-stigma ***:We searched relevant articles recorded in four scientifc databases from 1999 to 2022,using pre-defned inclusion and exclusion criteria,supplemented by the snowball method and complementary grey literature *** assessed the quality of studies using the Crowe Critical Appraisal Tool,then reviewed study characteristics,data on stigma measurement tools used,and interventions implemented,and designed a conceptual framework to illustrate the pathways to TB-stigma reduction in the interventions ***:Of 14,259 articles identifed,eleven met inclusion criteria,of which three were high ***-stigma reduction interventions consisted mainly of education and psychosocial support targeted predominantly toward three key populations:people with TB,healthcare workers,and the *** psychosocial interventions for people with TB set TB-stigma reduction as their primary or co-primary *** studies on healthcare workers and the public reported a decrease in TB-stigma attributed to the *** the benefts,the interventions were limited by a dearth of validated stigma measurement *** of eight studies with quantitative stigma measurement questionnaires had not been previously validated among people with *** qualitative studies used previously validated methods or tools to qualitatively evaluate *** the basis of these fndings,we generated a conceptual framework that mapped the population targeted,interventions delivered,and their potential efects on reducing TB-stigma towards and e

关键词： Tuberculosis Stigma Intervention Stigma measurement tool

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Effect of financial support on reducing the incidence of catastrophic costs among tuberculosis-affected households in Indonesia:eight simulated scenarios

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Infectious Diseases of Poverty 2019年第1期8卷 100-100页

作者： ahmad fuady Tanja A.J.Houweling Muchtaruddin Mansyur Erlina Burhan Jan Hendrik Richardus Departm ent of Public Health Erasmus MCUniversity Medical Centre RotterdamP.O.Box 20403000CARotterdamthe Netherlands Department of Community Medicine Faculty of MedicineUniversitas IndonesiaJakartaIndonesia 不详

Background:The World Health Organization's End Tuberculosis Strategy states that no tuberculosis(TB)-affected households should endure catastrophic costs due to *** achieve this target,it is essential to provide adequate social *** only a few studies in many countries have evaluated social-protection programs to determine whether the target is being reached,we assessed the effect of financial support on reducing the incidence of catastrophic costs due to TB in ***:From July to Septem ber 2016,we interviewed adult patients receiving treatment for TB in 19 primary health centres in urban,sub-urban and rural area of Indonesia,and those receiving multidrug-resistant(MDR)TB treatment in an Indonesian national referral *** on the needs assessment,we developed eight scenarios for financial *** assessed the effect of each simulated scenario by measuring reductions in the incidence of catastrophic ***:We analysed data of 282 TB and 64 MDR-TB *** incidences of catastrophic costs in affected households were 36 and 83%,***'primary needs for social protection were financial support to cover costs related to income loss,transportation,and food *** optimum scenario,in which financial support would be provided for these three items,would reduce the respective incidences of catastrophic costs in TB and MDR-TB-affected households to 11 and 23%.The patients experiencing catastrophic costs in this scenario would,however,have to pay high rem aining costs(median of USD 910;[interquartile range(IQR)662]in the TB group,and USD 2613;[IQR 3442]in the MDR-TB group).Conclusions:Indonesia's current level of social protection is not sufficient to mitigate the socioeconom ic im pact of *** support for income loss,transportation costs,and food-supplem ent costs will substantially reduce the incidence of catastrophic costs,but financial support alone will not be sufficient to achieve the target of

关键词： Tuberculosis Multidrug-resistant tuberculosis Catastrophic cost Social protection Financial support Cash transfer Indonesia

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