Determinants of tuberculosis diagnosis and the role of counselling.

OBJECTIVE

To study patient determinants that may affect completion of the diagnostic process in tuberculosis control, highlighting the role of counselling.

DESIGN

Cross-sectional study.

SUBJECTS: TB patients.

SETTING

Rhodes Chest Clinic, Nairobi, City Council.

RESULTS

Ninety five percent of the suspects delivered three sputum samples but only 27% consented to a HIV test; several determinants for none consenting were mentioned. On average US$2.27 was spent for one clinic visit and U.S. $8.62 for following the entire diagnostic process. Cost factors included transport, loss of income and food.

CONCLUSION

Individual pre-test counselling seems important for obtaining three sputum specimens. It takes time and for settings with a large number of suspects, alternative methods may be required. To obtain consensus for a HIV test in a TB clinic is complicated. Costs spent on transport and loss in income are important determinants and may contribute to poor patient adherence to the diagnostic process.