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Volume 28, Number 9—September 2022
Research

Costs of Tuberculosis at 3 Treatment Centers, Canada, 2010–2016

Jonathon R. Campbell, Placide Nsengiyumva, Leslie Y. Chiang, Frances Jamieson, Hadeel Khadawardi, Henry K.-H. Mah, Olivia Oxlade, Hayden Rasberry, Elizabeth Rea, Kamila Romanowski, Natasha F. Sabur, Beate Sander, Aashna Uppal, James C. Johnston, Kevin SchwartzmanComments to Author , and Sarah K. Brode
Author affiliations: McGill University, Montreal, Quebec, Canada (J.R. Campbell, P. Nsengiyumva, O. Oxlade, A. Uppal, K. Schwartzman); Research Institute of the McGill University Health Centre, Montreal (J.R. Campbell, P. Nsengiyumva, H. Rasberry, A. Uppal, K. Schwartzman); McGill International TB Centre, Montreal (J.R. Campbell, O. Oxlade, K. Schwartzman); British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada (L.Y. Chiang, K. Romanowski, J.C. Johnston); University of Toronto, Toronto, Ontario, Canada (F. Jamieson, E. Rea, B. Sander, S.K. Brode); Public Health Ontario, Toronto (F. Jamieson, B. Sander); West Park Healthcare Centre, Toronto (H. Khadawardi, H.K.-H. Mah, N.F. Sabur, S.K. Brode); Toronto Public Health, Toronto (E. Rea); University of British Columbia, Vancouver (K. Romanowski, J.C. Johnston); St. Michael’s Hospital, Toronto (N.F. Sabur); University Health Network, Toronto (B. Sander, S.K. Brode); Montreal Chest Institute, Montreal (K. Schwartzman)

Main Article

Table 3

Multivariable analysis of characteristics associated with increasing or decreasing costs of managing different forms of TB at 3 treatment centers, Canada, July 2010–June 2016*

Characteristic Cost ratio (95% CI)
All patients, n = 313 TB infection, n = 90 DS TB, n = 90 INHR TB, n = 71 MDR TB, n = 62
TB type
DS TB Referent NA NA NA NA
TB infection 0.09 (0.07–0.11) NA NA NA NA
INHR TB 1.7 (1.3–2.1) NA NA NA NA
MDR TB
8.1 (6.1–10.6)
NA
NA
NA
NA
Age group, y
<40 Referent Referent Referent Referent Referent
>40
0.97 (0.8–1.2)
1.3 (1.1–1.5)
0.9 (0.6–1.3)
1.2 (0.9–1.6)
0.9 (0.7–1.1)
Sex
F Referent Referent Referent Referent Referent
M
0.9 (0.8–1.1)
0.99 (0.8–1.2)
0.8 (0.6–1.1)
1.01 (0.8–1.4)
0.98 (0.8–1.3)
HIV
HIV-negative or unknown Referent NA† Referent NA† NA‡
HIV-positive
1.8 (0.6–5.4)
NA†
11.9 (2.7–52.0)
NA†
NA‡
Diabetes
No diabetes or unknown NA‡ NA‡ NA‡ Referent NA‡
Has diabetes
NA‡
NA‡
NA‡
1.4 (0.9–2.2)
NA‡
Adverse events causing drug stop
None Referent NA‡ Referent Referent NA‡
Because of >1 drug
1.4 (1.1–1.7)
NA‡
1.5 (1.03–2.0)
1.2 (0.9–1.7)
NA‡
Hospitalization
None or <2 mo NA NA Referent Referent Referent
>2 mo
NA
NA
3.7 (1.9–7.4)
3.2 (2.1–4.7)
1.5 (1.1–2.0)
AFB smear
Negative or unknown NA NA Referent Referent Referent
Positive
NA
NA
1.5 (0.98–2.2)
1.3 (0.9–1.7)
1.02 (0.8–1.3)
Cavities on chest radiograph
No or unknown NA NA Referent NA‡ Referent
Yes
NA
NA
1.2 (0.8–1.8)
NA‡
1.3 (0.96–1.8)
TB location
Pulmonary only NA NA Referent NA‡ NA‡
Extrapulmonary involvement
NA
NA
0.7 (0.5–1.1)
NA‡
NA‡
No. contacts
Per additional contact
NA
NA
1.05 (1.02–1.08)
1.02 (1.01–1.02)
1.01 (0.99–1.01)
Received DOT
No NA NA NA‡ Referent Referent
Yes
NA
NA
NA‡
2.0 (1.2–3.3)
0.8 (0.5–1.3)
TB infection regimen
Mono-rifampin NA Referent NA NA NA
Isoniazid-containing
NA
1.3 (0.97–1.7)
NA
NA
NA
MDR TB resistance pattern
MDR TB NA NA NA NA Referent
Fluoroquinolone-resistance, SLI resistance, or both NA NA NA NA 1.4 (1.02–2.0)

*AFB, acid-fast bacilli; DOT, directly observed therapy; DS, drug-susceptible; INHR, isoniazid-resistant; IQR, interquartile range; MDR, multidrug-resistant; NA, not applicable; SLI, second-line injectable; TB, tuberculosis. †No persons living with HIV in patient group. ‡Not retained in multivariable model because p>0.2 in univariable analysis.

Main Article

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Page updated: August 19, 2022
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