References in the content below refer to the PBMEF Guide.
Definitions
Percent of people with notified pulmonary TB who had a contact investigation (CI) initiated. CI initiated: For the purpose of this indicator, “initiated” refers to the process of enumeration of all known contacts to an index TB case. CI will include the evaluation of those contacts to determine if any have active TB disease or TB infection (TBI) through symptom screening, diagnostic testing, chest X-ray (CXR), or clinical evaluation. Index case: Person with pulmonary TB who is notified to health authorities.
Index case: Person with pulmonary TB who is notified to health authorities.
Calculation: (Numerator/Denominator) x 100
Numerator
Denominator
Ref # |
DT_CI_INIT
(Previously CI-8) |
Tier Level |
National Level Indicators
|
Category |
Reach
|
Type |
Outcome
|
Unit of Measure |
Percent of people with TB
|
Data Type |
Percentage
|
Disaggregations |
Age (0–4, 5–14, 15+)
Sex
|
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, monthly, or weekly basis is recommended.
|
Data sources include the TB register, CI register, laboratory testing register, and electronic management information systems available at the health facility and district level.
CI will reduce TB transmission in the community through early identification and treatment of people with active TB disease and identification and initiation of TPT for people with TBI. A World Health Organization (WHO) guideline review found an effective CI yield of 3.4% (95% CI: 2.9,3.8) among contacts to bacteriologically confirmed (bac+) index cases, 3.9% (95% CI: 2.5, 5.4) among contacts <5 years old, 3.7% (95% CI: 2.4, 5.3) among MDR/XDR contacts, and 11.6% (95% CI: 8.2,15.4) among contacts who were also HIV infected. [2022 WHO consolidated guidelines on tuberculosis. Module 2: screening – systematic screening for tuberculosis disease. pg. 17]
This indicator provides data to identify gaps in the first step of CI service delivery.
The percent of people with TB with CI initiated (the number of people with notified TB who had a CI initiated divided by the total number of people with notified TB) provides a measure of how thoroughly programs are conducting CI activities. When analyzed over time, it can identify gaps and opportunities to find unrecognized people with TB. This is the first step in the CI cascade. Broader CI cascade analyses can be used to identify ‘hot spots’ for drug- sensitive (DS) TB and drug-resistant (DR) TB in the community and trends over time to determine the number of contacts needed to screen (NNS) or the number of contacts needed to test (NNT) to find a new case. They can also provide information to understand contact-tracing performance and yield in health facilities and across subnational levels to guide implementation and planning for scale up.
Example charts/graphs:
- CI cascade
- Trends over time of percent of people with notified TB who have a CI initiated comparisons
- Scatterplot comparing coverage of people with TB with CI done and CI completed for contacts identified
Indicator Visualizations
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