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Table 6 Travel costs

From: Tuberculosis and poverty: the contribution of patient costs in sub-Saharan Africa – a systematic review

Author(s) year

Country

Cost estimate (I$)

% monthly per-capita income (entire population)

% monthly per-capital income (income-poorest 20% of the population)

Notes

Aspler, et al. [41]

Zambia

3

8

43

Median costs for pre-diagnosis (IQR I$1- I$7)

Aspler, et al. [41]

Zambia

12

31

171

Median costs for pill collection visits (IQR I$4- I$29)

Aspler, et al. [41]

Zambia

4

10

57

Median costs for follow-up visits (IQR I$2- I$4)

Bevan, E. [43]

Kenya

5

11

35

Daily cost to travel to a designated DOTS center

Cambanis, et al. [45]

Ethiopia

7

47

100a

Mean costs for transport to a health facility

Chard, S. [46]

Uganda

3

14

45b

Mean transportation costs to a health facility in Kampala

Chard, S. [46]

Uganda

5

21

67b

Mean transportation costs to a health facility in Mukono

Datiko and Lindtjorn [48]

Ethiopia

2

14

31c

Mean transport costs for a community-based DOTS treatment program (sd I$5)

Datiko and Lindtjorn [48]

Ethiopia

15

88

188c

Mean transport costs for a health facility-based DOTS treatment program (sd I$43)

Edginton, et al. [49]

South Africa

3

0.96

7d

Mid-point costs for 69% of hospital attendees and 48% of clinic attendees (range I$0.52-I$5)e

Floyd, et al. [51]

South Africa

12

4

20f

Mean travel cost for a hospital visit

Floyd, et al. [51]

South Africa

2

0.74

4f

Mean travel cost for a health clinic visit

Floyd, et al. [51]

South Africa

0.17

0.05

0.30f

Mean travel cost for a health clinic DOTS visit

Floyd, et al. [51]

South Africa

0.85

0.27

1f

Mean travel cost for a TB ward DOTS visit

Floyd, et al. [50]

Malawi

4

26

102

Mean costs for visit to a health center to collect drugs for smear-positive and -negative patients under hospital and community-based strategies (I$18 for average 5 visits)

Harper, et al. [53]

The Gambia

0.55

2

8g

Mean daily fare to attend a TB clinic (range I$0.44-I$0.66)

Kemp, et al. [54]

Malawi

18

116

456h

Mean transport costs for smear-positive patients (median I$11)

Kemp, et al. [54]

Malawi

13

81

319h

Mean transport costs for smear-negative patients (median I$5)

Mesfin, et al. [55]

Ethiopia

11

72

155

Mean transport costs for visiting a public health facility pre-diagnosis

Needham, et al. [58]

Zambia

9

26

150

Mean transportation cost during treatment (median I$3)

Nganda, et al. [60]

Kenya

9

20

67i

Mean cost for a visit to collect drugs from a health facility for smear-positive patients under conventional and community-based strategies for smear-positive patients (I$44 for average 5 visits)j

Okello, et al. [61]

Uganda

6

24

78k

Mean costs to the nearest health facility in an outpatient system and costs to collect drugs under the conventional hospital-based care strategy and the community-based care strategy for smear-positive patients (I$37 for average 5 visits)

Sinanovic, et al. [63]

South Africa

0.40

0.13

0.69m

Mean cost for monitoring and collection of drugs and a clinic-based DOTS visit in Guguletu, Cape Town (95% CI I$0.20- I$0.60)

Sinanovic, et al. [63]

South Africa

0.30

0.09

0.52m

Mean cost for monitoring and collection of drugs and a clinic-based DOTS visit in Nyanga, Cape Town (95% CI I$0.10- I$0.50)

Vassall, et al. [65]

Ethiopia

70

444

952

Mean pretreatment transportation costs (median I$4)n

Wilkinson, et al. [67]

South Africa

5

2

9 o

Average cost of a visit to a village clinicp

Wilkinson, et al. [67]

South Africa

20

6

34 o

Average cost of a visit to a hospitalp

Wilkinson, et al. [67]

South Africa

1

0.43

2 o

Average cost of a village clinic DOTS visit, a community health worker DOTS visit, and a non-health worker DOTS visitp

Wyss, et al. [68]

Tanzania

9

32

83 q

Weekly transportation costs

  1. a Income share based on 2005 estimates instead of 2004; b Income share based on 1999 estimates instead of 1998; c Income share based on 2005 estimates instead of 2006; d Income share based on 1993 estimates instead of 1994; e 29% of hospital attendees and 52% of clinic attendees reported to pay no cost in transportation fees, and 2% of hospital attendees and 0 clinic attendees paid more than I$5; f Income share based on 1995 estimates instead of 1996; g Income share based on 1998 estimates instead of 2000; h Income share based on 1998 estimates instead of 2000; i Income share based on 1997 estimates instead of 1998; j The conventional was approach used until 1997 in which new patients were hospitalized for the first month of treatment and subsequently provided unsupervised treatment for the next 11 months. The community-based approach was used after 1997 in which patients spent the first 2 months of treatment in DOTS outpatient programs and the remaining 6 months of treatment in unsupervised outpatient visits; k Income share based on 1999 estimates instead of 1998; l Income share based on 2004 estimates instead of 2005; m Income share based on 1995 estimates instead of 1997; n Note: these costs are over several months—the authors did not report single transportation costs; o Income share based on 1995 estimates instead of 1996; p Note: these costs include indirect time costs; q Income share based on 2000 estimates instead of 1996.