Costs and psychosocial burden of tuberculosis to the treatment supporters in Ghana

Abstract

Objectives: Tuberculosis treatment supporters contribute crucially to tuberculosis control and prevention without f inancial compensation. The World Health Organization recommends direct observation of treatment, involving supporters who incurred costs for frequent health facility visits and waiting times, potentially impacting their socio-economic status. This study aims to inform tuberculosis control and prevention policy by determining the costs and psychosocial burden associated with treatment support. Methods: A cross-sectional cost-of-illness approach, data from 385 supporters were collected through validated questionnaires. Both direct and indirect costs were assessed, with psychosocial burden measured using the Zarit Burden Interview (ZBI) 12-item questionnaire. Results: Results reveal that, on average, supporters spent GHS 122.4 (US$21.1) monthly, constituting 19 % of their income. A significant 77.1 % experienced a high burden on the ZBI scale, with females facing a greater burden than males. Socio-demographic factors such as education, household size, income, and district of resi dence influenced both direct and indirect costs. Conclusion: In conclusion, the study underscores the substantial costs and psychosocial burden on tuberculosis treatment supporters and recommends extending the livelihood empowerment against poverty program in Ghana to cover treatment support costs.