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The long term effect of pulmonary tuberculosis on income and employment in a low income, urban setting
- Source :
- Thorax
- Publication Year :
- 2021
- Publisher :
- BMJ Publishing Group, 2021.
-
Abstract
- BackgroundMitigating the socioeconomic impact of tuberculosis (TB) is key to the WHO End TB Strategy. However, little known about socioeconomic well-being beyond TB-treatment completion. In this mixed-methods study, we describe socioeconomic outcomes after TB-disease in urban Blantyre, Malawi, and explore pathways and barriers to financial recovery.MethodsAdults ≥15 years successfully completing treatment for a first episode of pulmonary TB under the National TB Control Programme were prospectively followed up for 12 months. Socioeconomic, income, occupation, health seeking and cost data were collected. Determinants and impacts of ongoing financial hardship were explored through illness narrative interviews with purposively selected participants.Results405 participants were recruited from February 2016 to April 2017. Median age was 35 years (IQR: 28–41), 67.9% (275/405) were male, and 60.6% (244/405) were HIV-positive. Employment and incomes were lowest at TB-treatment completion, with limited recovery in the following year: fewer people were in paid work (63.0% (232/368) vs 72.4% (293/405), p=0.006), median incomes were lower (US$44.13 (IQR: US$0–US$106.15) vs US$72.20 (IQR: US$26.71–US$173.29), pConclusionsTB-affected households remain economically vulnerable even after TB-treatment completion, with limited recovery in income and employment, persistent financial strain requiring dissaving, and ongoing school interruptions. Measures of the economic impact of TB disease should include the post-TB period. Interventions to protect the long-term health and livelihoods of TB survivors must be explored.
- Subjects :
- HD
Adult
Employment
Male
Pulmonary and Respiratory Medicine
Malawi
Tuberculosis
Psychological intervention
social determinants
wa_395
Dissaving
03 medical and health sciences
0302 clinical medicine
Poverty Areas
Humans
health economics
Medicine
Prospective Studies
030212 general & internal medicine
Social determinants of health
Economic impact analysis
Occupations
Tuberculosis, Pulmonary
Socioeconomic status
First episode
Health economics
TB sequelae
business.industry
Pulmonary tuberculosis
1. No poverty
Patient Acceptance of Health Care
medicine.disease
3. Good health
Socioeconomic Factors
030228 respiratory system
Income
Female
wf_200
business
RA
post-TB lung disease
wf_300
RC
Demography
Subjects
Details
- Language :
- English
- ISSN :
- 00406376
- Database :
- OpenAIRE
- Journal :
- Thorax
- Accession number :
- edsair.doi.dedup.....5bfdd177bdeac98e808bdcb6bd2f82ef