Percentage of TB patients who had an HIV test result recorded in the TB register [disaggegrated by sex (female, male), age (0-4, 5-14, 15 and above), and HIV status (HIV positive, HIV negative)]

Export Indicator

The percentage of TB patients who had an HIV test result recorded in the TB register in a given time period, disaggegrated by sex (female, male), age (0-4, 5-14, 15 and above), and HIV status (HIV positive, HIV negative).
What it measures

This indicator measures the coverage of HIV testing among tuberculosis (TB) patients.

Rationale

TB is the leading cause of morbidity and mortality among people living with HIV in many countries. In addition, high rates of HIV coinfection are found among TB patients in settings with high HIV prevalence. In these settings, ensuring that TB patients receive HIV testing and counselling services should be a high priority. Knowledge of HIV status enables HIV-positive TB patients to access the most appropriate HIV prevention, treatment, care and support services. Trends over time will demonstrate progress towards national and international targets.

Numerator

Number of TB patients registered during a given time period who had an HIV test result recorded in the TB register.
 

Denominator

Total number of TB patients registered during the same time period.
 

Calculation

Number of TB patients, registered during a given time period,
who had an HIV test result recorded in the TB register
-------------------------------------------------------------------------------------------------------------------- x 100
Total number of TB patients registered during the same time period

Method of measurement

Data for this indicator can be collected using national programme records aggregated from facility registers, either the TB register or a separate HIV testing and counselling register. Where available, data should come from the national TB control programme surveillance system and should include data from TB services delivered in public and private health facilities and prisons, as well as from TB services delivered by faith-based and nongovernmental organizations. Disaggregating the data by age and sex will enable assessment of equity of access to HIV counselling and testing services. Data should also be disaggregated based on the result of the HIV test.

GFATM: The numerator should include all TB patients who were previously known to be HIV-positive (documented evidence of enrollment in HIV care) or their negative HIV result from previous testing was acceptable to the clinician (such as performed in the past three to six months in a reliable laboratory).

Ideally, all TB patients with unknown HIV status should be offered an HIV test, preferably within the context of the TB service provider, allowing the HIV test to be recorded in the patient record and the TB register. Patient confidentiality must be maintained. Where HIV counseling and testing is carried out in a different part of the same facility or even at a distant site, a referral system needs to be established so that the TB program records when a TB patient is referred for an HIV test and receives the result. TB patients should preferably be tested at the start of TB treatment so that they can benefit from appropriate care throughout TB treatment. However, a recording and reporting system should be able to capture these late tests; otherwise the total number of TB patients knowing their HIV status will be underreported.

This indicator measures the combined services’ ability to ensure that TB patients know their HIV status under program conditions. If a high proportion of TB patients know their status, then this provides a sufficiently robust estimate of the true HIV prevalence among TB patients for surveillance purposes. It also forms the basis for more in-depth prevention efforts (such as condoms and partner testing) and access to care and treatment.

Measurement frequency

Annual

Disaggregation

Age group: 4 years - 14 years, > (greater than) 15 years

Gender: Male, Female

HIV status: HIV positive, HIV negative

Time period: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

This indicator is generated from the WHO standardized M&E system recommended for national TB programmes. These data will help national TB control programmes to project national requirements for HIV tests and related commodities, as well as national requirements for human resources training. Tracking this number from year to year will provide information on whether provider-initiated HIV testing and counselling is being targeted and provided appropriately to patients with TB, so that HIV-positive TB patients can access appropriate HIV services. A limitation of the indicator is that health care providers may treat TB without registering with the national TB control programme, which means that those individuals would not be counted in this indicator.

Further information