References in the content below refer to the PBMEF Guide.
Definitions
Percent of people with new and relapse pulmonary TB who have drug susceptibility testing (DST) results for 1) rifampicin, 2) isoniazid, 3) fluoroquinolones, 4) bedaquiline, and 5) linezolid.
Calculation: (Numerator disaggregate: DST type (1,2,3,4 or 5*)/Denominator) x 100
*Note 5 separate proportions should be calculated, one for each drug type.
Numerator
Denominator
Ref # |
NEWREL_DST
|
Tier Level |
Core Plus Indicator
|
Category |
Reach
|
Type |
Outcome
|
Unit of Measure |
Percent of people
|
Data Type |
Percentage
|
Disaggregations |
Age (0–4, 5–14, 15+)
Sex
DST type
HIV Status
|
Reporting Level |
All Core Plus 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.
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The data sources are the basic management unit TB register and electronic management information systems at the health facility and district level. Components of this indicator can also be calculated using the WHO Global TB Programme database variables:
Numerator:
- Rifampicin: r_rlt_new
- Isoniazid: dst_rlt_new
Denominator: new_labconf + ret_rel_labconf
DST coverage is an important step in the drug-resistant (DR)-TB detection and treatment cascade.
Drug-sensitivity testing helps to measure the magnitude of drug resistance for anti-TB medicines among people with notified TB, which is a key information for any NTP to understand the burden of DR-TB and respond accordingly. DST coverage indicates a country’s ability to detect drug resistance among people with active TB disease and initiate people diagnosed with DR-TB on appropriate treatment regimens. Data on DST coverage are valuable for planning laboratory equipment and supplies as well as drug logistics and supervision.
Though data for DST on all 5 drugs may not be available, countries should be working to implement this testing over time, along with accompanying data collection and reporting.
All people with bacteriologically confirmed TB should have DST results documented for at least rifampicin to ensure that people with DR-TB are rapidly identified and placed on the correct treatment regimen in a timely manner. The denominator for this indicator only includes people with bacteriologically confirmed TB. In countries where bacteriological confirmation is low, the performance of this indicator may appear high even when DST testing among all people with TB is relatively low. In such instances, countries may want to examine this percent for clinically diagnosed as well as bacteriologically confirmed TB.
Early detection of resistance to rifampicin ensures that an appropriate drug regimen can be prescribed to increase the chance of treatment success, and to reduce the chance of acquiring additional resistance. It also helps to reduce the risk of transmission of DR-TB.
This indicator flows from the core indicator of bacteriologic confirmation among people with notified pulmonary TB and provides the basis to calculate relevant indicators such as rate of positivity, type of resistance, and treatment initiation rate. It helps to track progress and investment in coverage of testing for drug resistance in order to monitor performance for early detection of DR-TB and timely initiation for care and treatment. This indicator can also be presented in a graph with the number of new bacteriologically confirmed pulmonary TB patients (pulm_labconf_new).
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