People living with HIV who started TB preventive therapy

Export Indicator

Number of people who started treatment for latent TB infection, expressed as a percentage of the total number of people newly enrolled in HIV care during the reporting period
What it measures

The extent to which people living with HIV newly registered in HIV care start treatment for latent TB infection.

Rationale
All people in HIV care should be screened for TB at every visit, using a clinical algorithm recommended by WHO. Adults and adolescents living with HIV who do not report any of the symptoms—current cough, fever, weight loss or night sweats—are unlikely to have active TB and should be offered TB preventive therapy: that is, treatment for latent TB infection. Similarly, children who do not have poor weight gain, fever or current cough should
be offered TB preventive therapy to reduce the risk of developing active TB, both those receiving antiretroviral therapy and those who do not.
Numerator
Total number of people living with HIV newly enrolled in HIV care who start treatment for latent TB infection during the reporting period.
 
If data on people newly enrolled in HIV care starting TB preventive treatment are not available, enter data for those starting treatment for latent TB infection among all people living with HIV who are currently enrolled in HIV care.
Denominator
Total number of people newly enrolled in HIV care: that is, those registered for pre-antiretroviral therapy or antiretroviral therapy during the reporting period. This denominator should be the same as the denominator of Indicator 10.2.
 
If data on people newly enrolled in HIV care starting TB preventive treatment are not available, enter the number of people living with HIV who are currently enrolled in HIV care.
Calculation

Numerator/denominator

Method of measurement
TB preventive therapy should be started for all eligible people and the start date recorded on the HIV care/antiretroviral therapy card (encounter section). Those who accept treatment and receive at least the first dose should then be recorded in the pre–-antiretroviral therapy and antiretroviral therapy registers (isoniazid start month and year column).
 
Numerator. Count the total number of people living with HIV newly enrolled in HIV care during the reporting period who start treatment for latent TB infection: that is, those who receive at least one dose of anti-TB drugs such as isoniazid.
 
Denominator. Count the total number of people living with HIV newly registered for pre-–antiretroviral therapy plus those registered for antiretroviral therapy during the reporting period.
 
For accurate planning and drug management, more detailed information needs to be collected in addition to the above. A pharmacy-based register may be used to record client attendance and drug collections. Alternatively, the antiretroviral therapy facility may maintain a latent TB infection treatment register in parallel with the antiretroviral therapy register. Such a record may provide valuable information on the number of new and
continuing patients on latent TB infection treatment, as well as treatment completion rates and adverse events.
 
See Annex 5 for further understanding of the indicator.
 
If data on people newly enrolled in HIV care starting TB preventive treatment are not available:
 
Numerator: Count the number of people living with HIV who are currently enrolled in HIV care who started TB preventive therapy during the reporting period.
 
Denominator: Count the number of people living with HIV who are currently enrolled in HIV care during the reporting period.
Measurement frequency
Data should be recorded daily and reported quarterly to the national or subnational level. They should be consolidated annually and reported to UNAIDS.
Disaggregation

Cities

Additional information requested
Please provide city-specific data for this indicator. Space has been created in the data entry sheet to provide information for the capital city as well as one or two other key cities of high epidemiological relevance: for example, those that have the highest HIV burden or have committed to ending AIDS by 2030.
Strengths and weaknesses
This indicator measures the coverage of TB preventive therapy among people newly enrolled in HIV care. However, it lacks the benchmark for acceptable performance. Scaling up this intervention will assist in developing such a benchmark at the national level. Unless further data are collected, this indicator provides no information on the number of individuals who adhere to or complete the course of treatment.
Further information
A guide to monitoring and evaluation for collaborative TB/HIV activities: 2015 revision. Geneva: World Health Organization; 2015 (http://www.who.int/tb/publications/monitoring-evaluation-collaborative-t...).