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.