Box 1 Glossary of operational definitions for tuberculosis disease, treatment and costs

Patient registration group: Classification of TB based on history of previous TB treatment

New case: Patient who has never been treated for TB before

Retreatment case: Patient treated with anti-TB drugs in the past and are now on treatment after the following

∙ Relapse (previously completed treatment/cured)

∙ Treatment failure (last treatment failed at the end of treatment)

∙ Loss to follow up (patients who did not complete their last treatment)

TB treatment phases:

Intensive phase: the first two consecutive months of TB treatment

Continuation phase: the four consecutive months immediately following the intensive treatment phase

During treatment: the period of time spanning from the beginning of the intensive treatment phase to the end of continuation treatment phase

Model of care:

Community Directly Observed Treatment Strategy (DOTS): Patient receives ambulatory care; collects medicine from the health facility biweekly or weekly

Facility based DOTS: Patient receives medicine at the health facility under observation, usually on a daily basis

Hospitalization: Patient is treated as an inpatient until symptoms are stabilized

DOTS supporter/treatment supporter:

Refers to person, often family member who accompanies the patient to the hospital or stays with the patient during a hospitalization event. Could also be the DOTS supporter i.e. observes/reminds patient to take medicine at the specified time

Treatment delay:

Time between the onset of symptoms and the start of treatment. For this study the threshold is 4 weeks

TB costs

∙ Direct medical costs: costs of medical examinations and medicines, including hospitalization

∙ Direct non-medical expenses: costs of, TB-care-related transport, accommodation, natural remedies and other miscellaneous expenses. Also includes costs incurred by guardian or treatment supporter

∙ Direct costs: the sum of the direct medical costs and direct non-medical costs (above)

∙ Lost income (indirect costs): the income the patient estimated that the household lost due to TB illness or when seeking care/treatment. This also includes costs incurred from onset of symptoms and prior to presentation for TB diagnosis

∙ Total costs: direct costs plus lost income

Household (HH):

People that live together under the same roof, often with family relations, and share at least one meal a day