Proportion of household that face catastrophic costs due to TB (output approach) according to different thresholds, type of costs, and quintiles of wealth, Colombia, 2021.

Proportion of household that face catastrophic costs due to TB (output approach) according to different thresholds, type of costs, and quintiles of wealth, Colombia, 2021.</p

Total costs incurred by TB-affected households during one TB episode in Colombia, 2021, assessed by human capital method (in US$).

Total costs incurred by TB-affected households during one TB episode in Colombia, 2021, assessed by human capital method (in US$).</p

Proportion of household that face catastrophic costs due to TB according to different thresholds and type of costs (human capital method).

Proportion of household that face catastrophic costs due to TB according to different thresholds and type of costs (human capital method).</p

Reported coping mechanisms and social consequences in households affected by TB in Colombia, 2021.

Reported coping mechanisms and social consequences in households affected by TB in Colombia, 2021.</p

S1 Checklist -

ObjectiveTo estimate the baseline to measure one of the three indicators of the World Health Organization (WHO) End TB strategy (2015–2035), measure the costs incurred by patients affected by tuberculosis (TB) during a treatment episode and estimate the proportion of households facing catastrophic costs (CC) and associated risk factors, in Colombia, 2021.Material and methodsA nationally representative cross-sectional survey was conducted among participants on TB treatment in Colombia, using telephone interviews due to the exceptional context of the COVID-19 pandemic. The survey collected household costs (direct [medical and non-medical out-of-pocket expenses] and indirect) over an episode of TB, loss of time, coping measures, self-reported income, and asset ownership. Total costs were expressed as a proportion of annual household income and analyzed for risk factors of CC (defined as costs above 20% annual household income).ResultsThe proportion of TB-affected households incurring in costs above 20% annual household income (CC) was 51.7% (95%CI: 45.4–58.0) overall, 51.3% (95%CI: 44.9–57.7) among patients with drug-sensitive (DS) TB, and 65.0% (95%CI: 48.0–82.0) among drug-resistant (DR). The average patient cost of a TB case in Colombia was $1,218 (95$860.9 (95%CI 776.1–945.7) for non-medical costs, $339 (95$18.1 (95%CI 11.9–24.4) for the medical costs. The factors that influenced the probability of facing CC were income quintile, job loss, DR-TB patient, and TB type.ConclusionMain cost drivers for CC were non-medical out-of-pocket expenses and income loss (indirect costs). Current social protection programs ought to be expanded to mitigate the proportion of TB-affected households facing CC in Colombia, especially those with lower income levels.</div

Percentage of households affected by tuberculosis that incur catastrophic costs with different thresholds (20% and others) in Colombia, 2021.

Percentage of households affected by tuberculosis that incur catastrophic costs with different thresholds (20% and others) in Colombia, 2021.</p

Risk factors for TB-affected households facing costs >20% of household income or expenditure due to TB in Colombia, 2021.

Risk factors for TB-affected households facing costs >20% of household income or expenditure due to TB in Colombia, 2021.</p

Total costs incurred by TB-affected households during one TB episode in Colombia, 2021 (with indirect costs assessed using output approach in US$).

Total costs incurred by TB-affected households during one TB episode in Colombia, 2021 (with indirect costs assessed using output approach in US$).</p

Changes in the work situation before and after an episode of tuberculosis in Colombia, 2021.

Changes in the work situation before and after an episode of tuberculosis in Colombia, 2021.</p

Model of care for TB, treatment duration and treatment delay survey participants, Colombia, 2021.

Model of care for TB, treatment duration and treatment delay survey participants, Colombia, 2021.</p