The long term effect of pulmonary tuberculosis on income and employment in a low income, urban setting
| Autor: | Fatima Chitimbe, Jamilah Meghji, Kevin Mortimer, Stephen Bertel Squire, Stephen B. Gordon, Jamie Rylance, Rachael Thomson, Jason Madan, Elizabeth L. Corbett, Stefanie Gregorius, Ndaziona Pk Banda |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
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 |
| Zdroj: | Thorax |
| ISSN: | 0040-6376 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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