Table 1.
Discrete choice experiment attributes and attribute levels to evaluate patient preferences for improving tuberculosis services in Zambia.
Fig 1.
Study flow diagram.
Table 2.
Baseline characteristics by enrollment site and HIV status.
Fig 2.
Tuberculosis patient care pathways in Zambia, according to HIV status by enrolment site.
Table 3.
Overview of TB patient care pathway according to enrollment site and HIV status.
Fig 3.
Barriers and facilitators to tuberculosis care engagement in Zambia: (a) reasons for delayed health-seeking among patients who contemplated presenting to care sooner than they did (n = 217); (b) reasons for seeking healthcare (n = 401); (c) reasons for choosing initial site/facility for evaluation and care (n = 401).
Fig 4.
Patient preferences for improving tuberculosis care services in Zambia: The average utilities (zero-centered) for enhanced TB facility features.
Abbreviations: KM = kilometers, TB = tuberculosis, ZMK = Zambian Kwacha.
Fig 5.
Tradeoffs patients were willing to make in order to access a facility offering different enhanced services: (a) additional willingness to travel (in kilometers), (b) additional willingness to wait (in hours).
Willingness to travel and wait values were calculated using the following assumptions for a “usual” tuberculosis health facility in Lusaka, Zambia: it is 2 kilometers from an individual’s home, requires two hours spent at the clinic waiting and undergoing evaluation (based on the median amount of time cited by survey participants on their date of TB diagnosis), it is only be open during typical business hours Monday through Friday, an individual may be known or recognized there, is does not offer sex-concordant health care providers, it does not offer financial incentives for undergoing TB testing, and it requires individuals to return on a different day to collect their TB test results. Because it is not feasible to implement same-day TB testing without an additional wait time for patients, in the willingness’s to travel analyses, we assumed that patients would need to wait an additional 3 hours (minimum estimated time required for sample collection and transport, Xpert testing, and result notification), or 6 hours (total wait time of 5 or 8 hours, respectively), in order to access same-day TB testing.