Direct costs of pulmonary tuberculosis among patients receiving treatment in Bauchi State, Nigeria

Nisser Umar, I Abubakar, Richard Fordham, Max Bachmann

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16 Citations (Scopus)


BACKGROUND: To access tuberculosis (TB) services, patients have to bear the costs of out-of-pocket expenditures or direct costs for transport, drugs and other services that are not provided free-of-charge. These costs could represent a barrier to care, especially in a country such as Nigeria, where per capita gross national income is only US$1160 and 46% of the urban population live below the poverty line.
OBJECTIVE: To describe the direct costs of TB diagnosis and treatment in Bauchi State, Nigeria, from the patient's perspective.
METHODS: A cross-sectional study. A sample size of 255 patients was randomly selected from 27 of 67 facilities in Bauchi State, Nigeria.
RESULTS: The median out-of-pocket cost for hospitalised patients was estimated at US$166.11, while ambulatory patients paid an estimated median cost of US$94.16, equivalent to about 9-38% of their average annual income. Female patients spent a higher proportion of their income on diagnosis and treatment than males (P < 0.0001). The median out-of-pocket costs borne by patients before, during and after diagnosis were estimated at respectively US$35.23, US$27.12 and US$23.43 for ambulatory patients, and additional average out-of-pocket spending of US$66.44 for patients hospitalised during their illness. Pre-diagnosis, diagnosis and post-diagnosis out-of-pocket spending did not vary significantly by human immunodeficiency virus status (P > 0.05) and sex (P > 0.05).
CONCLUSION: The costs of anti-tuberculosis treatment found in this study are expensive and potentially catastrophic for many patients and their families.
Original languageEnglish
Pages (from-to)835-40
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Issue number6
Publication statusPublished - 1 Jun 2012


  • Young Adult
  • Nigeria
  • Financing, Personal
  • Health Expenditures
  • Humans
  • Chi-Square Distribution
  • Aged
  • Child
  • Health Services Accessibility
  • Models, Economic
  • Income
  • Ambulatory Care
  • Health Care Costs
  • Drug Costs
  • Cross-Sectional Studies
  • Tuberculosis, Pulmonary
  • Adult
  • Treatment Outcome
  • Middle Aged
  • Hospital Costs
  • Antitubercular Agents
  • Adolescent
  • Male
  • Female

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