References in the content below refer to the PBMEF Guide.
Definitions
Number of people with presumptive TB identified during the reporting period.
Presumptive TB: people who screened positive for any signs or symptoms of TB are considered to have suspected TB disease and are said to have presumptive TB; these people should receive diagnostic testing with a WHO-recommended rapid diagnostic (WRD).
Numerator
Denominator
Ref # |
DT_PRES
(Previously PS-2) |
Tier Level |
Project Level Indicators
|
Category |
Reach
|
Type |
Output
|
Unit of Measure |
Number of people
|
Data Type |
Integer
|
Disaggregations |
Age (0–4, 5–14, 15+)
Sex
|
Reporting Level |
National and subnational
|
Reporting Frequency |
Monthly, quarterly
|
The data sources are basic management unit TB register, screening register, presumptive TB register, cough register, outpatient department registers, contact investigation (CI) register, or electronic management information systems available at the health facility and district level.
Active case finding (ACF) or systematic screening for TB is an important tool to reach missing people with TB. It helps to reduce diagnosis and treatment delays and prevents the spread of the disease. Screening for active TB may reduce TB incidence, prevalence, and mortality; however, yield of ACF interventions varies substantially across populations.
Passive case finding, putting the burden of care seeking for TB on the patient, alone will not achieve the 90% treatment coverage target set out in many national strategic plans (NSPs) and global strategies. In high burden TB settings and among populations with poor access and uptake of TB diagnosis and care, systematic screening of people, particularly those in high risk groups (i.e. HIV positive, contacts, prisoners), at both health facility-based and community based levels are crucial.
To achieve universal access to early accurate diagnosis of TB and enhancing case finding efficiency, identification of people with presumptive TB at the first point of care and linking them to the best available diagnostic tests is essential to program management and strategy of patient centered care.
The indicator helps to demonstrate how effective the screening process is at identifying people who might have TB. Screening and diagnosing patients with appropriate tests and strategies will largely help project and national program response to TB case finding. It measures case detection efforts by the National TB Program (NTP) and stakeholders.
A high rate of presumptive TB can mean that clinicians only send patients with advanced disease for diagnostic testing and are unaware of the symptoms of TB. On the contrary, if the rate is low, the screening tools have a low specificity and are not picking up people who are likely to have TB.
Cascade analysis of the screening and diagnosis program data will be helpful to highlight the gaps in case finding and steps to take in addressing the barriers. In addition, trend analyses will be appropriate to help the use of information.
Example charts/graphs:
- Trends over time and comparisons by risk group, geographic areas and by location (i.e. community-based or facility-based)
- ACF cascade
- Number of people eligible for screening
- Number of people screened for TB
- Number of people with presumptive TB
- Number of people with presumptive TB tested
- Number of people with presumptive TB diagnosed with TB
- Number of people with confirmed TB starting TB treatment
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