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Sung J, Musinguzi A, Kadota JL, Baik Y, Nabunje J, Welishe F, Bishop O, Berger CA, Katahoire A, Nakitende A, Nakimuli J, Akello L, Kasidi JR, Kunihira Tinka L, Kamya MR, Sohn H, Kiwanuka N, Katamba A, Cattamanchi A, Dowdy DW, Semitala FC. Understanding patient-level costs of weekly isoniazid-rifapentine (3HP) among people living with HIV in Uganda. Int J Tuberc Lung Dis 2023; 27:458-464. [PMID: 37231600 DOI: 10.5588/ijtld.22.0679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND: Twelve weeks of weekly isoniazid and rifapentine (3HP) prevents TB disease among people with HIV (PWH), but the costs to people of taking TB preventive treatment is not well described.METHODS: We surveyed PWH who initiated 3HP at a large urban HIV/AIDS clinic in Kampala, Uganda, as part of a larger trial. We estimated the cost of one 3HP visit from the patient perspective, including both out-of-pocket costs and estimated lost wages. Costs were reported in 2021 Ugandan shillings (UGX) and US dollars (USD; USD1 = UGX3,587)RESULTS: The survey included 1,655 PWH. The median participant cost of one clinic visit was UGX19,200 (USD5.36), or 38.5% of the median weekly income. Per visit, the cost of transportation was the largest component (median: UGX10,000/USD2.79), followed by lost income (median: UGX4,200/USD1.16) and food (median: UGX2,000/USD0.56). Men reported greater income loss than women (median: UGX6,400/USD1.79 vs. UGX3,300/USD0.93), and participants who lived further than a 30-minute drive to the clinic had higher transportation costs than others (median: UGX14,000/USD3.90 vs. UGX8,000/USD2.23).CONCLUSION: Patient-level costs to receive 3HP accounted for over one-third of weekly income. Patient-centered approaches to averting or defraying these costs are needed.
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Affiliation(s)
- J Sung
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A Musinguzi
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - J L Kadota
- Division of Pulmonary and Critical Care Medicine and Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA
| | - Y Baik
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - J Nabunje
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - F Welishe
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - O Bishop
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - C A Berger
- Division of Pulmonary and Critical Care Medicine and Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA
| | - A Katahoire
- Child Health and Development Centre, Makerere University College of Health Sciences, Kampala, Uganda
| | - A Nakitende
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - J Nakimuli
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - L Akello
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - J R Kasidi
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - L Kunihira Tinka
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
| | - M R Kamya
- Infectious Diseases Research Collaboration, Kampala, Uganda, Department of Internal Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - H Sohn
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - N Kiwanuka
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - A Katamba
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda, Department of Internal Medicine Clinical Epidemiology Unit, Makerere University College of Health Science, Kampala, Uganda
| | - A Cattamanchi
- Division of Pulmonary and Critical Care Medicine and Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA, Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda, Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, CA, USA
| | - D W Dowdy
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - F C Semitala
- Infectious Diseases Research Collaboration, Kampala, Uganda, Department of Internal Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda, Makerere University Joint AIDS Program, Kampala, Uganda
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Kadota JL, Katamba A, Musinguzi A, Welishe F, Nabunje J, Ssemata JL, Berger CA, Kamya MR, Namusobya J, Semitala FC, Cattamanchi A, Dowdy DW. Willingness to accept reimbursement for visits to an HIV clinic for tuberculosis preventive therapy. Int J Tuberc Lung Dis 2021; 24:729-731. [PMID: 32718409 DOI: 10.5588/ijtld.20.0010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- J L Kadota
- Division of Pulmonary and Critical Care Medicine and Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA
| | - A Katamba
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda, Department of Medicine, Makerere University, Kampala, Uganda
| | - A Musinguzi
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - F Welishe
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - J Nabunje
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - J L Ssemata
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - C A Berger
- Division of Pulmonary and Critical Care Medicine and Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA
| | - M R Kamya
- Department of Medicine, Makerere University, Kampala, Uganda, Infectious Diseases Research Collaboration, Kampala, Uganda
| | - J Namusobya
- University Research Company, Center for Human Services, Department of Defense HIV/AIDS Prevention Program (URC-DHAPP), Kampala, Uganda
| | - F C Semitala
- Department of Medicine, Makerere University, Kampala, Uganda, Infectious Diseases Research Collaboration, Kampala, Uganda, Makerere University Joint AIDS Program, Kampala, Uganda
| | - A Cattamanchi
- Division of Pulmonary and Critical Care Medicine and Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA, Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
| | - D W Dowdy
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, ,
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