References in the content below refer to the PBMEF Guide.
Definitions
Percentage of people with drug-resistant tuberculosis (DR-TB) (rifampicin-resistant [RR-TB]/multidrug-resistant [MDR]-TB, pre-extensively drug-resistant [pre-XDR]-TB, and extensively drug-resistant [XDR]-TB) successfully treated (cured or treatment completed) among all people with DR-TB who were initiated on treatment during the reporting period.
Note: This indicator might include patients with polydrug resistant TB (PDR-TB) if they are part of the RR/MDR recording in the national database. However, if PDR-TB is reported separately, they should not be included in DR-TB TSR calculations.
Treatment outcomes are defined by the time period 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 2020. For this reason, reports of treatment outcome data lag by 2 years.
Calculation: (Numerator/Denominator) x 100
Numerator
Denominator
Ref # |
DR_TSR
(Previously RS-1) |
Tier Level |
Core Indicator
|
Category |
Cure
|
Type |
Core Outcome
|
Unit of Measure |
Percent of people
|
Data Type |
Percentage
|
Disaggregations |
Age (<15, 15+)
Sex
|
Reporting Level |
All Core PBMEF indicators should be reported at the national level; data may also be collected subnationally for more granular monitoring.
|
Reporting Frequency |
This indicator should be reported on a semiannual basis at a minimum. More frequent monitoring on a quarterly or monthly basis is recommended. Performance plans and reports (PPRs) for this indicator are based on calendar year (CY) periodicity to reflect national level attainment and align with the USAID congressional reporting requirements.
|
This indicator is reported by National TB Program (NTP) official records. Quarterly report on TB treatment outcomes in the basic management unit and Combined annual outcomes report for basic TB and for MDR-TB/RR-TB.
This standard World Health Organization (WHO) indicator can also be calculated using the WHO database. The variable for the numerator is mdr_succ plus xdr_succ and the denominator is mdr_coh plus xdr_coh.
DR-TB treatment success measures a TB program’s ability to initiate people with DR-TB on appropriate treatment and support patients throughout the entire course of DR-TB treatment. This final outcome is the most important measure of the effectiveness of the DR-TB program in terms of patient care. Therefore, it is also a performance indicator for the NTP as a whole.
Although improving in some countries, the treatment success rate reported in 2021 for DR-TB globally remains low at 71% for MDR-TB/RR-TB. Access to costly drugs, poor treatment adherence, poor treatment management, adverse side effects, and comorbidities leading to death or loss to follow-up (LTFU) are all factors that contribute to low DR-TB treatment success. However, the wider use of more effective, shorter, and “all oral” DR-TB treatment regimens, as well as more patient-centered models of care, are expected to improve treatment success rates. The USAID TB strategy (2023-30) targets for 90% of people with DR-TB to be successfully treated. Improvements in DR-TB treatment success can help to reduce the overall TB mortality rate. High treatment success coupled with high treatment coverage among those diagnosed with DR-TB are both critical to interrupting transmission of DR-TB and reducing morbidity and mortality due to DR-TB in a country.
DR-TB treatment success rate can be analyzed as a trend over time and compared to national and global DR-TB treatment success rate targets. A cascade can also be constructed to highlight gaps in care where some patients could be lost. The gap between treatment initiation and treatment success can be further broken down to understand why patients were unsuccessful with treatment (e.g., death, treatment failure, moved to pre-XDR treatment, or unknown outcomes).