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Determinants of tuberculosis diagnosis and the role of counselling
L Kivihya-Ndugga1, M Van Cleeff, J Nyamwaya
1Center for Respiratory Diseases Research, Kenya Medical Research Institute, P.O. Box 47855-00100, Nairobi, Kenya.
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.
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