Can Malawi's poor afford free tuberculosis services? Patient and household costs associated with a tuberculosis diagnosis in Lilongwe.

Objective: To assess the relative costs of accessing a TB diagnosis for the poor and for women in urban Lilongwe, Malawi, a setting where public health services are accessible within 6 kilometers and provided free of charge.

Methods: Patient and household direct and opportunity costs were assessed from a survey of 179 TB patients, systematically sampled from all public and mission health facilities in Lilongwe. Poverty status was determined from the 1998 Malawi Integrated Household Survey (MIHS).

High incidence of tuberculosis in prison officers in Zomba, Malawi.

We conducted a study in four prisons in Zomba district, Malawi, to determine the tuberculosis case notification rate in prison officers during the year 2000. Of 201 prison staff, 9 (4.5%) were diagnosed with TB: 2 with smear-positive pulmonary tuberculosis (PTB), 4 with smear-negative PTB and 3 with extrapulmonary TB (EPTB).