Percent of HIV-positive patients who were screened for TB in HIV care or treatment setting

Export Indicator

Percent of HIV-positive patients who were screened for TB in HIV care or treatment setting
What it measures

TB disease is the leading cause of mortality among PLWH. Screening for TB among PLWH at initial and subsequent visits is recommended to identify TB suspects and link them to diagnosis and treatment. Currently, available data indicates that despite successes in selected sites, national scale-up of TB screening has been slow in most countries.

Rationale

This indicator will help USG to monitor the proportion of HIV-positive patients who are screened for active TB disease. The data collected from countries using this indicator will allow USG to monitor increases over time. HQ can use this data to identify countries that are making progress and document experiences and lessons learned that may be useful to other countries. HQ can also use this data to identify countries that may require additional programming and technical assistance. Similarly, country teams and partners can use this data to assess scale-up of TB screening among PLWH in specific sites.

Numerator

Number of HIV-positive patients who were screened for TB in HIV care or treatment setting

Denominator

Denominator is indicator number C2.1.D (HIV+ Care indicator)

Calculation

Numerator / Denominator

Method of measurement

The numerator can be generated by counting the number of HIV-positive adults and children in HIV care or treatment (pre-ART or ART) who were screened for TB disease during the reporting period, at last visit.

Denominator: Indicator C2.1.D
Explanation:

Numerator: HIV positive patients should be screened for TB on a regular basis to identify TB suspects and link them to diagnosis and treatment for active TB disease. Currently this information is not fully documented in the revised WHO Pre-ART and ART register. Programs should modify the register as needed to easily capture this information.

The TB screening algorithm applied to identify TB suspects who require additional evaluation for TB disease should be consistent with National TB Program recommendations and best practices. This may include a symptom screening questionnaire (i.e. cough, fever, night sweats, recent weight loss,
lymphadenopathy) or chest x-ray. Patients who “screen positive” should be referred for further evaluation, diagnosis, and treatment as appropriate. IPT may be considered for eligible patients in whom TB has been excluded if recommended in National Guidelines.

The TB screening algorithm applied to identify TB suspects who require additional evaluation for TB disease should be consistent with National TB Program recommendations and best practices. This may include a symptom screening questionnaire (i.e. cough, fever, night sweats, recent weight loss,

Measurement frequency

Continuously

Disaggregation

Age group:

Condom type: N/A

Education: N/A

Gender: N/A

Geographic location: N/A

HIV status: N/A

Pregnancy status: N/A

Sector: N/A

Service Type: N/A

Target: N/A

Time period: N/A

Type of orphan: N/A

Vulnerability status: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

This indicator is intended to provide information on the proportion of HIV-positive patients in HIV care and treatment who are screened for TB at last visit. We assume that if we check to see if a patient was screened for TB at last visit, this will reflect regular TB screening at each visit. An increase in this indicator suggests that a higher proportion of HIV patients are being screened for TB and increased efforts. For example, developing a standard screening algorithm, training HIV staff, revising cards/registers, etc. A decrease in this indicator suggests that a lower proportion of PLWH are being screened for TB and change in policy or program. For example, a turnover in trained staff, decreased supervision visits, shortage of screening tools, etc.

Further information