Tuberculosis (TB) is a global health challenge. Currently it is the 7th leading cause of death worldwide, and Nigeria ranks fourth amongst 22 high-burden countries for the disease. This study sought to appraise the direct and indirect costs borne by TB patients attending the Chest Clinics at the Lagos State University Teaching Hospital, Ikeja and Mainland Hospital, (formerly Infectious Disease Hospital), Yaba, both in Lagos, Nigeria.
A cross-sectional study was conducted in July 2008, recruiting all consenting TB patients that had commenced treatment at the Chest Clinics of the Lagos State University Teaching Hospital, Ikeja and Mainland Hospital, Yaba, Lagos, Nigeria. Data were collected with the aid of 205 pretested, self-administered questionnaires and analysed with the Statistical Package for the Social Sciences (SPSS, version 12.0; SPSS Inc. 2003). Long-run average costs were employed in accordance with the World Health Organisation’s (WHO) Guidelines for Cost and Cost-
Effectiveness Analysis of Tuberculosis Control, converting at US$1=N120.
Throughout the duration of treatment, the typical TB patient earned an annual income of fifteen thousand, seven hundred and ninety five thousand naira only (N15, 795), equivalent to about one hundred and thirty-two dollars (US$132) and spent 7% of this on transport fare to attend his clinic daily. Direct costs (medical and non-medical) ranged between US$113 and US$401 with an average of US$161.28. This equates to 10% of the typical patient’s annual income (123% of the mean monthly income). Mean number of days lost from work due to TB was 45. TB disrupted working relationships, threatened jobs and led to actual loss of jobs (8%). Patients also lost about 13% of their annual income (US$199) in indirect costs.
Direct and indirect costs of TB are exorbitant in Nigeria, and are especially due to poor social infrastructure and transport facilities.