A cost analysis of the tuberculosis control programme in Elsies River, Cape Town

SETTING: Four primary health care clinics located in the suburb of Elsies River in the metropolitan area of Cape Town. AIM: To measure the cost of the Tuberculosis Control Programme to the health service in Elsies River and determine the costs associated with each of the clinic, community and self-supervised methods of treatment of pulmonary tuberculosis patients. DESIGN: A cost analysis designed to assess the resource input requirements of the three alternative programmes of implementing the supervision of antituberculosis therapy. The main outcome measurement was the estimated cost per patient treated for the health services by three different supervision methods (clinic, self and community-based). RESULTS: The estimated cost per patient for a 6-month period in each of the supervision groups (clinic, self and community) was R3 600, R1 080 and R720 respectively. CONCLUSION: Directly observed therapy, short-course (DOTS), has been adopted as the recommended policy for managing tuberculosis in South Africa. The costs incurred by the variety of supervision options evaluated in this study indicate that community-based directly observed therapy by a volunteer lay health worker may be less costly to the health services than either clinic or self supervision.