Ciobanu A, Plesca V, Doltu S, Manea M, Domente L, Dadu A
University of Medicine and Pharmacy 'Nicolae Testemitanu', Chisinau, Republic of Moldova.
WHO Regional Office for Europe, Copenhagen, Denmark.
IJTLD Open. 2024 Jun 1;1(6):266-273. doi: 10.5588/ijtldopen.23.0608. eCollection 2024 Jun.
The Republic of Moldova is a lower-middle-income country. Patients with TB face some barriers to accessing TB services. Welfare benefits are available during TB treatment.
We aimed to determine the proportion of rifampicin-resistant TB (RR-TB) households that experienced catastrophic costs due to TB at a threshold of ≥20% of household income and investigate the associated risk factors.
A cross-sectional countrywide study comprised 430 patients with RR-TB who had received TB treatment as an inpatient or outpatient for at least 2 months.
RR-TB patients lost 30% of their household income in inpatient and 70% in outpatient TB care. TB-related costs were associated with being unofficially employed or unemployed (aOR 1.9, 95% CI 1.1-3.3), having fewer household members (aOR 2.1, 95% CI 1.3-3.5), having an income that accounted for over 50% of household income (aOR 2.4, 95% CI 1.5-3.8), and being a poor household (aOR 2.2, 95% CI 1.2-3.9).
Although TB health services are provided to patients free of charge, 26% of RR-TB households experienced catastrophic TB costs. The associated factors should be considered to improve patient-centred TB care, especially in vulnerable groups. Welfare payments mitigate TB costs.
摩尔多瓦共和国是一个中低收入国家。结核病患者在获得结核病服务方面面临一些障碍。结核病治疗期间可享受福利补助。
我们旨在确定利福平耐药结核病（RR-TB）家庭中因结核病导致灾难性费用的比例（阈值为家庭收入的≥20%），并调查相关危险因素。
一项全国性横断面研究，纳入430例接受住院或门诊结核病治疗至少2个月的RR-TB患者。
RR-TB患者住院治疗使家庭收入损失30%，门诊治疗使家庭收入损失70%。与结核病相关的费用与非正规就业或失业（调整后比值比[aOR] 1.9，95%置信区间[CI] 1.1 - 3.3）、家庭成员较少（aOR 2.1，95% CI 1.3 - 3.5）、收入占家庭收入超过50%（aOR 2.4，95% CI 1.5 - 3.8）以及贫困家庭（aOR 2.2，95% CI 1.2 - 3.9）有关。
尽管为患者免费提供结核病医疗服务，但26%的RR-TB家庭仍经历了结核病灾难性费用。应考虑相关因素以改善以患者为中心的结核病护理，尤其是在弱势群体中。福利支付可减轻结核病费用。
