Measuring the catastrophic cost of diagnosis, treatment, care, and support on people and families affected by tuberculosis in Iran and Afghanistan

Objectives A key goal of the World Health Organization's End Tuberculosis (TB) Plan was to eliminate TB-related catastrophic costs by 2030. This study aimed to measure the achievement of two countries (Iran and Afghanistan) in this plan. Design or methods Using a random cluster sampling, 649 patients with TB were interviewed in 2020. This study calculated the direct, indirect, and catastrophic costs for Iran and Afghanistan and applied regression estimators and a sensitivity analysis. Results The results showed that 49% of households in Afghanistan and 20% of households in Iran faced TB-related catastrophic costs. Being in multidrug-resistant treatment (odds ratio [OR] = 3.670) was related to facing catastrophic costs. Households with a female (OR = 0.532), being an Iran resident (OR = 0.429), and being a university degree-holder (OR = 0.284) patient with TB had a lower likelihood of facing catastrophic costs. Conclusion The findings of this study showed that these two countries are far from the goals of the World Health Organization for having zero TB-related catastrophic costs.