Factors influencing utilization of diagnostic counselling and testing for HIV among tuberculosis patients at Monze mission hospital ,Zambia

Introduction
The burden of Tuberculosis (TB) in Zambia is one of the highest in the world. The incidence of TB has risen in recent years, partly as a result of the impact of the HIV and AIDS epidemic.Therefore, Diagnostic Counselling and Testing(DCT) was recommended as part of the treatment package of tuberculosis patient.This will help improve the patient‟s quality of life, delaying and preventing complications and deaths due to opportunistic infections that could arise from late detection of HIV/AIDS.Diagnostic Counselling and Testing can best be achieved by information, communication and education to patients with Tuberculosis(TB) on the importance of testing early. The objective of the study was to examine the utilization of DCT and associated factors among patients with TB at Monze Mission Hospital in Southern province of Zambia.
Methods: An institutional-based cross-sectional study was conducted at Monze Mission Hospital chest clinic. Simple random sampling method was used to select in/out patients with tuberculosis from within the hospital.Data was collected from patients who consented for enrolment from October to December 2014. A semi-structured interview schedule was used to collect data. The relationships between the different categories of variables were investigated using Pearson‟s Chi squared test for association and further fitting logistic regression model. The independent variables were determined to be significantly associated with the outcome variables after bivariate Chi-square testing were included into the logistic regression model. Binary logistic regression analysis of data was carried out using IBM® SPSS®Statistics for Windows version 20.0 to predict factors influencing DCT.
Results: A total of 226 patients were sampled and out of which, 150 (66.7%) did not utilize DCT and 76 (33.3%) utilized DCT. Diagnostic Testing and Counselling was aassociated with the level of knowledge and confidentiality. The p value of level of knowledge and confidentiality were less than 0.05 and therefore failed to reject the null hypothesis. Multivariate binary logistic regression model predicted that confidentiality and knowledge were associated with DCT at p value < 0.05

Conclusion: This study established that the level of knowledge and confidentiality influenced DCT utilization. There is need, therefore, to consider full use of DCT for detecting HIV/AIDS early so as to prevent opportunistic infections. DCT will improve the management of the patients with tuberculosis. Furthermore, studies should be done to evaluate the role of patients with tuberculosis in the management of their condition.