References in the content below refer to the PBMEF Guide.
Definitions
Number of people with drug-resistant (DR) TB (rifampicin-resistant [RR] and multidrug-resistant [MDR] and pre-extensively drug-resistant [pre-XDR] and extensively drug-resistant [XDR] TB) with each of the defined DR-TB treatment outcomes, among the cohort of people who were initiated on DR-TB treatment during a defined reporting period.
Cohort reporting: Treatment outcomes are defined by the time of initiation on treatment; e.g., “2018 cohort successfully treated” reflect those who were initiated on treatment in 2018, even though treatment may have extended into 2019 or 2020. For this reason, reports of DR-TB treatment outcome data lag by 1–2 years.
Numerator
Denominator
Ref # |
TX_DR_OUT_NEVAL
(Previously RS-5) |
Tier Level |
National Level Indicators
|
Category |
Cure
|
Type |
Outcome
|
Unit of Measure |
Number of people
|
Data Type |
Integer
|
Disaggregations |
Age (<15, 15+)
Sex
HIV Status
|
Reporting Level |
National Level indicators should be reported at the national level; data may also be reported subnationally or at the project level if national data is not available.
|
Reporting Frequency |
This indicator should be reported on an annual basis at a minimum. More frequent monitoring on a quarterly or monthly basis is recommended.
|
The data sources are basic management unit DR-TB register or electronic management information systems available at the health facility and district level. Quarterly DR-TB cohort analysis reports may also be used if these analyses are being conducted. The following WHO indicators can be used to report this indicator:
Not Evaluated: (mdr_coh + xdr_coh) - (mdr_succ + xdr_succ + mdr_died + xdr_died + mdr_lost + xdr_lost + mdr_fail + xdr_fail)
Systematic analysis of treatment outcomes for people initiated on DR-TB treatment is an important activity to track the quality of TB services and measures the National TB Program’s (NTP) ability or inability to support people to successfully complete DR-TB treatment. Monitoring various treatment outcomes reported under this indicator is useful in understanding reasons for suboptimal treatment success, which is a key outcome in the USAID TB strategy.
High death rates may be indicative of people who were not identified with DR-TB early enough, problems with treatment regimens, or poor treatment management. High treatment failure rates can be indicative of problems with choice of second-line treatment regimen, drug quality, poor clinical management of DR-TB and/or a lack of treatment adherence support services. High LTFU can be indicative of poor treatment management and/or a lack of treatment support services; high numbers of people not evaluated can also be indicative of poor patient management or poor documentation practices.
Cohort analysis of treatment outcomes is a major management tool for monitoring the effectiveness of the National TB Program. The data reported for each treatment outcome in this indicator should be compared to the cohort size which is reported with the core indicator for DR-TB TSR; to determine the percent of people with each outcome, divide the number of people with the outcome by the number of people in the cohort (mdr_coh + xdr_coh).
The percent of people who experienced each DR-TB treatment outcome can be analyzed as a trend to show improvements in treatment outcomes over time.
Monitoring this indicator is important as countries strive to reach zero deaths due to TB, but it can also prompt NTPs to implement additional or better-targeted treatment support services for people with DR-TB, with the aim of improving treatment outcomes.
Example charts/graphs:
- DR-TB outcome pie chart
- Trend over time comparisons
- DR-TB treatment cascade