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Percent of HCWs Diagnosed with TBI

References in the content below refer to the PBMEF Guide.

Definitions

Percent of healthcare workers (HCWs) tested positive for TB infection (TBI) during the reporting period, among those who were tested for TBI.

HCW: A frontline HCW who is providing direct services including TB screening, contact evaluation, diagnosis, treatment, and patient care or support.

Numerator

Number of HCWs tested positive for TBI during the reporting period

Denominator

Number of HCWs who were tested for TBI during the reporting period
Ref #
HCW_TBI_POS
(Previously HW-6)
Tier Level
Project Level Indicators
Category
Prevent
Type
Outcome
Unit of Measure
Percent of HCWs
Data Type
Percentage
Disaggregations
Sex
Type of HCW
Type of Facility
TBI Diagnostic Method
Reporting Level
Project Level indicators are expected to be reported at the subnational level for subnational units where the partner is operating. National data may also be reported if 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 TB register, HCW screening register, contact investigation (CI) register, laboratory register, and electronic management information systems available at the health facility and district level.

This indicator complements indicator HW-1, “Percent of HCWs screened for TB.” It is important to diagnose TBIs in HCWs to prevent nosocomial transmission, particularly among immunocompromised patients. If HCWs are diagnosed with infectious TB, the impact of TB transmission at the health facility can be considerable because of immunocompromised patients in healthcare systems. Therefore, periodic screenings and preventive treatment for TBI for HCWs at high-risk of TBI are recommended.

This metric is one indicator that measures the robustness of a country’s TB screening program.

The percent of HCWs screened for TBI can be analyzed over time and/or by comparing the percent of HCWs screened by various disaggregations, such as subregion, private vs. public health facilities, sex of HCWs, or age of HCWs (e.g., under 30, 30–39, 40–49, 50–59, 60 and older). This can provide insight into which regions or facilities have strong HCW screening protocols and which ones may be lagging; if there are discrepancies in screening by age or sex of HCWs; or if screening HCWs for TBI has improved, declined, or maintained over time.

Additionally, using a cascade analysis can indicate where there are gaps along the TB screening, notification, and treatment continuum for HCW. This analysis will provide a useful explanation for why a country may or may not be achieving its targets, what course corrections may be needed to address nosocomial transmission of TB, and which gaps in programming may require additional resources.

Examples of data visualizations:

  • Bar graph of percent of HCWs screened by type of HCW
  • Bar graph of percent of HCWs screened by region over a 10- or 20-year period
  • Stacked bar graph of percent of HCWs screened by region or by sex
  • HCW screening cascade
    • HCW screened for TB
    • Presumptive TB
    • Confirmed TB 
    • Screened negative of TB
    • Tested for TBI
    • Tested positive for TBI
    • Initiated on TB preventive treatment (TPT)
    • Completed TPT
There are no related indicators for this indicator.

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Changelog

March, 2024: Updated the name, definition, and other information based on the Interim PBMEF Tuberculosis Indicator Compendium.