{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:07:52Z","timestamp":1791526072903,"version":"4.3.4"},"reference-count":26,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJTLD Open"],"accepted":{"date-parts":[[2026,3,27]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Multidrug-resistant TB (MDR-TB) in children remains a major public health challenge. Although treatment is free of direct charge in many countries, it can impose substantial indirect and non-medical costs on affected households. Evidence on the economic burden of childhood MDR-TB on families remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A cross-sectional household survey was conducted in the Western Cape, South Africa, among 45 households with a child &lt;15 years who initiated MDR-TB treatment between 2018 and 2021. Socio-economic status, costs of accessing care, and health-related quality of life (HRQoL) were assessed and linked to health service utilisation data to estimate household-level costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The median total cost per household was ZAR 7,443 (US$504) per episode of care (interquartile range: ZAR 4,119\u201313,207), with indirect costs accounting for the largest share of household costs. Twenty-three (51.1%) of households incurred catastrophic health expenditure, defined as &gt;20% of annual household income. Costs increased with hospital-based care, longer treatment duration, and more frequent caregiver visits. The HRQoL of children was generally high, though not uniformly distributed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Childhood MDR-TB places substantial financial burden on already vulnerable households. Economic evaluations and care models should incorporate household costs and consider strategies to reduce the indirect burden of treatment on families.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5588\/ijtldopen.25.0616","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T02:34:08Z","timestamp":1783996448000},"page":"435-443","source":"Crossref","is-referenced-by-count":1,"title":["Household costs and health-related quality of life of childhood multidrug-resistant TB in Western Cape, South Africa"],"prefix":"10.5588","volume":"3","author":[{"given":"T.","family":"Wilkinson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.C.","family":"Hesseling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Hoddinott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.G.","family":"Anthony","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.S.","family":"Schaaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Sinanovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.A.","family":"Seddon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3554","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"2026071319340310000_3.7.435.1","unstructured":"World Health Organization . 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