Abstract
Background: The Democratic Republic of Congo (DRC) is one of the high burden TB countries. The country has been affected by a political conflict for more than 15 years now. HIV prevalence has been increasing in the country too. Detection and care of TB/HIV co-infected cases is a major problem in the country. Aim: This study aimed at describing patterns of health seeking behaviors among patients with TB/HIV regarding their choice of health facilities for integrated TB/HIV care in the Goma and surrounding health districts. Methods: The methods used included a cross-sectional descriptive survey with TB/HIV co-infected patients and qualitative interviews of health workers. Results: The study found that geographical residence did not play a major role in choice of facility for care by patients infected with TB and HIV. Many patients shun facilities which are close and seek care relatively far away. Instead of geographical proximity, availability of drugs and welcoming attitudes determined the choice of integrated care facilities. Also, fear for discrimination and stigmatization in the community result into patients in this area concealing their infection; rather, they claim being victim of empoisoning. Conclusion: Sustained decentralization of integrated TB/HIV services through better programs’ coordination and community involvement to address misconceptions about TB and HIV and stigmatization are essential to promote uptake of TB/HIV services and retain patients in treatment.
Highlights
The Democratic Republic of Congo (DRC) is one of twenty the high-burden Tuberculosis (TB) countries that together account for 80% of the global disease burden [1]
Based on the demographic information that estimates the population in the concerned districts at 586 250 persons [10], a sample size calculation based on a 4.4% HIV prevalence in NordKivu [11] indicated that a target sample of 379 patients would be needed
The results of this study showed that more than half of the patients received in health facilities came from areas outside of the concerned health districts
Summary
The Democratic Republic of Congo (DRC) is one of twenty the high-burden Tuberculosis (TB) countries that together account for 80% of the global disease burden [1]. DRC occupies the 11th position among these countries, with an incidence of more than 325 cases per 100,000 people per year [1]. According to WHO estimates, up to 27% of adults with TB are positive for HIV [1]. This co-infection challenge is even complicated by increasingly prevalent multi-resistant TB, due to poor treatment adherence. The Democratic Republic of Congo (DRC) is one of the high burden TB countries. Education level Primary Secondary Tertiary No level completed Illiterate Total Marital status Single Married Widow/widower Divorced Living in partnerships Total Frequencies (%)
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