The impact of pulmonary tuberculosis morbidity on household production, consumption, investment and community participation in Prey Veng province, Cambodia

Tuberculosis (TB) is a major public health problem in Cambodia where its impact on household production is little known. This study aimed to assess the impact of pulmonary TB morbidity on the production, financial resources and rice seeds used for investment, satisfaction with food and non-food consumption, and participation in a community of households and to inform policy makers of better strategies to mitigate this impact. During October-November 2014, 186/186 TB /chronic disease cases were randomly recruited into the study. A TB case was defined as a household that had one patient diagnosed with pulmonary TB from one of the 24 health centers in Prey Veng Province, Cambodia. A chronic disease case was defined as a household that had a patient diagnosed with other chronic illnesses and lived in the same area of TB cases. Head of household completed the study questionnaire on socio-demographic and economic characteristics, satisfaction with food and non-food consumption, financial resources and rice seeds used for investment, and participation in the community. Mean (SD) ages of patients with TB and chronic disease were 47.8(12.9) and 51.7(9.6) years, respectively. Annual household expenditure of TB cases vs. chronic disease cases was US$2,339.50 vs. US$2,869.30, p=0.008. Reduction in household consumption, investment in assets, child education and community participation was reported for TB and chronic disease cases. Reduction of non-agricultural household production of TB cases was significantly more than that of chronic disease cases (US$49.00 vs. US$ 7.30), p=0.006. Annual household expenditure and income of TB cases were lower than that of chronic disease cases. This suggests that free health care for TB might help to reduce the household expenditure of TB cases; however, pulmonary TB morbidity still caused greater loss of household production, in particular, income earned from non-agricultural production than other chronic diseases did. Further studies are needed to determine the best way to assist TB patients’ house production in rural areas during the treatment in a sustainable manner.