Tuberculosis patients with higher levels of poverty face equal or greater costs of illness

S. Erlinger, N. Stracker, C. Hanrahan, B. A.S. Nonyane, L. Mmolawa, R. Tampi, A. Tucker, N. West, L. Lebina, N. A. Martinson, D. Dowdy

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


S E T T I N G: Fifty-six public clinics in Limpopo Province, South Africa. O B J E C T I V E: To evaluate the association between tuberculosis (TB) patient costs and poverty as measured by a multidimensional poverty index. D E S I G N: We performed cross-sectional interviews of consecutive patients with TB. TB episode costs were estimated from self-reported income, travel costs, and care-seeking time. Poverty was assessed using the South African Multidimensional Poverty Index (SAMPI) deprivation score (a 12-item household-level index), with higher scores indicating greater poverty. We used multivariable linear regression to adjust for age, sex, human immunodeficiency virus status and travel time. R E S U LT S: Among 323 participants, 108 (33%) were ‘deprived’ (deprivation score .0.33). For each 0.1-unit increase in deprivation score, absolute TB episode costs were 1.11 times greater (95%CI 0.97–1.26). TB episode costs were 1.19 times greater with each quintile of higher deprivation score (95%CI 1.00–1.40), but lower by a factor of 0.54 with each quintile of lower self-reported income (higher poverty, 95%CI 0.46–0.62). C O N C L U S I O N: Individuals experiencing multidimensional poverty and the cost of tuberculosis illness in Limpopo, South Africa faced equal or higher costs of TB than non-impoverished patients. Individuals with lower self-reported income experienced higher costs as a proportion of household income but lower absolute costs. Targeted interventions are needed to reduce the economic burden of TB on patients with multidimensional poverty.

Original languageEnglish (US)
Pages (from-to)1205-1212
Number of pages8
JournalInternational Journal of Tuberculosis and Lung Disease
Issue number11
StatePublished - Nov 1 2019


  • Income
  • K E Y W O R D S: multidimensional poverty index
  • Patient costs

ASJC Scopus subject areas

  • General Medicine


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