Cost effectiveness of community-based (DOT) and self-supervised treatment of tuberculosis in Maracha Arua, Uganda
Tuberculosis is the leading infectious killer of people living with HIV/AIDS. Millions of tuberculosis deaths could be prevented by the widespread use of the less expensive strategy of directly observed treatment (DOT). The cost-effectiveness of DOT however varies with its method of supervision. This study evaluated the cost-effectiveness of community-based and self-supervision strategies of DOT in Maracha, Arua District, Uganda. Patients', community's and health system's costs were obtained through interviews and expenditure statements. For effectiveness measures, historical follow-up of the cohort belonging to each the tB treatmentt supervison strategy was done. Systematic random sampling was done to identify the 20 patients from each treatment strategy for interviews to estimate their treatment costs. Due to low number of patients in the available TB registers, all the 129 patients were enrolled for the study. The findings showed that community-based supervision of DOT was a more cost-effective TB treatment supervision option than that by self-supervision and was therefore recommended to Maracha HSD and Arua District for more support and expansion. However, the accuracy of this study was limited by method used and generalizability of the results could be affected by the small sample size.
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Department of Public Health and Family Medicine