title: 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.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  TB patients.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Center for Respiratory Diseases Research, Kenya Medical Research Institute, P.O. Box 47855-00100, Nairobi, Kenya.
authors.forename: L
authors.initials: L
authors.lastname: Kivihya-Ndugga
authors.forename: M
authors.initials: M
authors.lastname: Van Cleeff
authors.forename: J
authors.initials: J
authors.lastname: Nyamwaya
authors.forename: B
authors.initials: B
authors.lastname: Miheso
authors.forename: E
authors.initials: E
authors.lastname: Ndalo
authors.forename: J
authors.initials: J
authors.lastname: Odhiambo
authors.forename: P
authors.initials: P
authors.lastname: Klatser
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000503:physiopathology; D000328:Adult; D003376:Counseling; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007630:Kenya; D008297:Male; D010349:Patient Compliance; D013183:Sputum / Q000821:virology; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000175:diagnosis* / Q000503:physiopathology