Percentage of adults and children enrolled in HIV care and eligible for co-trimoxazole (CTX) prophylaxis (according to national guidelines) currently receiving CTX prophylaxis

Export Indicator

Percentage of adults and children enrolled in HIV care and eligible for co-trimoxazole (CTX) prophylaxis (according to national guidelines) currently receiving CTX prophylaxis
What it measures

Provision and coverage of CTX prophylaxis for adults and children enrolled in HIV care according to national criteria.

Rationale

Cotrimoxazole (CTX) prophylaxis is a critical intervention for HIV-infected adults and children for prolonging life, reducing greatly the incidence of major opportunistic infections and bacterial infections. It is critical to associate CTX
prophylaxis with ART to prevent infections during immune recovery.

Numerator

Number of adults and children enrolled in HIV care, eligible for CTX prophylaxis (in accordance with the national CTX prophylaxis guidelines) and receiving it at their last visit (in accordance with the national CTX prophylaxis guidelines) recorded during the reporting period

Denominator

Number of adults and children enrolled in HIV care and eligible for CTX prophylaxis at their last visit (in accordance with national CTX prophylaxis guidelines) recorded during the reporting period

Calculation

Numerator / Denominator

Method of measurement

This indicator can be obtained through the use of annual sample of HIV patient cards.

Numerator: In the encounter page of the HIV care/ART card, check the WHO stage and CD4 columns for last available CD4 and WHO clinical stage and determine CTX eligibility in accordance to the national CTX prophylaxis
recommendation. For those eligible, in the CTX column count all those on CTX at last visit.

Denominator: Count all those who are eligible for CTX prophylaxis in accordance with national CTX prophylaxis guidelines at last visit in the reporting period.

Disaggregation Age: Pregnancy Status: HIV-infected pregnant women

Data Quality Control and Notes for the Reporting Tool:
National Representativeness: If this indicator is obtained from a sub-set of facilities, comments should be added regarding the representativeness. Please comment on how the data was derived.
Denominator Issues: The proportion of people enrolled in HIV care eligible for CTX may depend on national policy. Please comment on any assumptions made about those in HIV care eligible for CTX.
Triangulation Options: pharmacy registers

Measurement frequency
Disaggregation

Age group: (greater than) 14 years

Pregnancy status: Pregnant, Not Pregnant

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

Despite national policy, CTX prophylaxis is not always fully implemented. In addition low coverage might reflect potential bottlenecks in the system such as poor management of CTX supply, poor data collection and inadequate distribution system.

Additional considerations: This indicator that reflects coverage should also be interpreted in view of the
national recommendations for CTX.

Data utilization: General idea of whether those who require CTX are receiving it. Explore disaggregated value to see whether there are patterns at individual facility of a sub-national level (e.g. stock outs in specific places) which can be addressed.

Further information