DETERMINANTS OF TUBERCULOSIS DIAGNOSIS AND THE ROLE OF COUNSELLING

Abstract

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 US$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.