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

From: Determinants of household catastrophic costs for drug sensitive tuberculosis patients in Kenya

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