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 financial 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.