Economic burden of caring for Pediatric Tuberculosis patients among households in Jinja District, Uganda: a cross-sectional study

Introduction Tuberculosis (TB) is an important source of economic devastation, revolving poverty, and illness. It has ensnared families, societies, and even countries globally, with the most vulnerable groups being women, children, and HIV patients. The economic burden of the disease is likely to increase among pediatric TB patients because it affects caregivers. Therefore, we assessed the economic burden faced by households with pediatric and adolescent TB patients aged 0 to 19 years in Jinja district. Methods We used an incidence-based, ingredient-based approach to estimate societal and household costs which included out-of-pocket costs and lost income incurred during pediatric TB treatment. Catastrophic health expenditures (CHE) were calculated based on the percentage of income spent on TB care among 324 caregivers of pediatric and adolescent TB patients aged 0–19 years (1st July, 2023 to 30th June, 2024). We used proportionate to size and systematic sampling. Descriptive analysis was used to determine the CHE if it spent more than the following thresholds on pediatric TB management: 10% of its income, 20% of its monthly expenditures or 40% of its monthly expenditures without food. Results Out of 324 caregivers, 74.1% were women and 34.0% participants aged 30–39 years. While TB drugs were provided for free, caregivers incurred an average cost of US $ 1.42 for diagnosis, US $ 0.57 for hospitalization, US $ 2.49 for travel, and US $ 1.36 for food during treatment. The overall mean cost of TB care per caregiver was US $ 4.10 excluding food, and US $ 5.33 with food. In addition to direct costs, caregivers also experienced productivity losses, with a median cost of US $ 12.97. CHE was experienced by 43.5% households at the 10% income threshold, decreasing to 22.5% and 18.2% at the 25% and 40% thresholds, respectively. Conclusion While TB medicines were free at governmental facilities, half of the families caring for children with TB experienced CHE. This increased economic burden on the already financially vulnerable families. Therefore, there is need for social support systems for the caregivers such as offering them with food vouchers.