Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2010 Feb 17;5(2):e9158.
doi: 10.1371/journal.pone.0009158.

Cost and cost-effectiveness of smear-positive tuberculosis treatment by Health Extension Workers in Southern Ethiopia: a community randomized trial

Daniel G Datiko  1 , Bernt Lindtjørn
Affiliations
Randomized Controlled Trial

Cost and cost-effectiveness of smear-positive tuberculosis treatment by Health Extension Workers in Southern Ethiopia: a community randomized trial

Daniel G Datiko et al. PLoS One. .

Abstract

Treatments by HEWs in the health posts and general health workers at health facility were compared along a community-randomized trial. Costs were analysed from societal perspective in 2007 in US $ using standard methods. We prospectively enrolled smear positive patients, and calculated cost-effectiveness as the cost per patient successfully treated. The total cost for each successfully treated smear-positive patient was higher in health facility ($158.9) compared with community ($61.7). Community-based treatment reduced the total, patient and caregiver cost by 61.2%, 68.1% and 79.8%, respectively. Involving HEWs added a total cost of $8.80 (14.3% of total cost) on health service per patient treated in the community.

Conclusions/significance: Community-based treatment by HEWs costs only 39% of what treatment by general health workers costs for similar outcomes. Involving HEWs in TB treatment is a cost effective treatment alternative to the health service, to the patients and the family. There is an economic and public health reason to consider involving HEWs in TB treatment in Ethiopia. However, community-based treatment requires initial investment to start its implementation, training and supervision.

Trial registration: ClinicalTrials.gov NCT00803322.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Tuberculosis patient costs under DOT options.
Blue bar - Health facility DOT. Red bar - Community DOT.
Figure 2
Figure 2. Caregiver costs under DOT options.
Blue bar - Health facility DOT. Red bar - Community DOT.
Figure 3
Figure 3. Costs per successfully treated smear-positive tuberculosis patient.
Blue bar - Health facility DOT. Red bar - Community DOT.
See this image and copyright information in PMC

References

    1. World Health Organization. Geneva, Switzerland: World Health Organization; 2008. Global Tuberculosis Control, surveillance, planning and financing. pp. 1–304.
    1. Yassin MA, Datiko DG, Shargie EB. Ten-year experiences of the tuberculosis control programme in the southern region of Ethiopia. Int J Tuberc Lung Dis. 2006;10:1166–1171. - PubMed
    1. Federal Ministry of Health of Ethiopia. Health and health related indicators. Ministry of Health of Ethiopia. 2007.
    1. Maher D, Harries A, Getahun H. Tuberculosis and HIV interaction in sub-Saharan Africa: impact on patients and programmes; implications for policies. Trop Med Int Health. 2005;10:734–742. - PubMed
    1. Federal Ministry of Health of Ethiopia. Tuberculosis, Leprosy and TB/HIV Prevention and Control Manual, Ministry of Health, Ethiopia. Addis Ababa. 2008.

Publication types

Associated data