Challenges Faced by Multidrug-Resistant Tuberculosis Patients in Three Financially Affluent Chinese Cities

Peize Zhang,1,* Guanghui Xu,2,* Yanhua Song,3,* Jie Tan,1 Tao Chen,1 Guofang Deng1 1Department of Pulmonary Medicine & Tuberculosis, The Third People’s Hospital of Shenzhen, Shenzhen, People’s Republic of China; 2Jiangmen Institute of Tuberculosis Prevention and Control, Guangdong, People’s Republic of China; 3Department of Tuberculosis, Chest Hospital of Peking, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guofang Deng Email jxxk1035@yeah.netPurpose: The aim of this study was to analyze socioeconomic burdens and other difficulties that multidrug-resistant tuberculosis (MDR-TB) patients in cities are facing, to identify major obstacles and which groups of patients are most affected.Methods: Face-to-face and phone-call interviews were conducted in early 2018 to follow-up with patients newly diagnosed with MDR-TB in 2017 in three tuberculosis hospitals in three financially affluent Chinese cities. Demographic data and information on their medical care, insurance coverage, and medical expenses were collected and analyzed.Results: A total of 144 newly diagnosed MDR-TB cases were reviewed during the study period, excluding 38 who were lost to follow-up and 29 patients who refused to participate, 77 patients were enrolled in this study. A total of 61 (79%) of these patients were hospitalized after MDR-TB diagnosis with an average hospital stay of 14 days, of them 57 (74%) were sputum positive on diagnosis. The proportion of patients who failed community care were 48% married, 56% in white collar employment and 43% in temp jobs/unemployed. In terms of insurance coverage, the proportion of patients who failed community care were 23% with no insurance and/or New Rural Co-operative Medical Care Scheme (NRCMS) and 45% with Urban Employee Basic Medical Insurance (UEBMI)/Urban Residents Basic Medical Insurance (URBMI) and commercial insurance. Difficulties patients encountered were, financial pressure (33%), psychological stress (26%), adverse drug reactions (23%), ...