References in the content below refer to the PBMEF Guide.
Definitions
Percent of people with previously treated (including relapse) pulmonary TB who have drug susceptibility test (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 # |
RET_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.
|
The data sources are basic management unit TB register, rifampicin-resistant (RR) and multidrug-resistant (MDR) TB register, and electronic management information systems available 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_ret
- Isoniazid: dst_rlt_ret
Denominator: pulm_labconf_ret
The risk of drug resistance is high among people with previously treated TB, particularly among those treated irregularly, or with incorrect regimens and doses. Many studies have reported that the most important risk factor for the development of drug-resistant (DR)-TB is the previous treatment of TB. Hence, DST coverage among people with previously treated TB (including relapse) provides valuable data to monitor coverage of drug-sensitivity testing for anti-TB drugs among this high-risk group. It also helps to understand the prevalence and types of drug resistance. This indicator gives the basis to conduct further cascade analysis for DR-TB diagnosis, such as linkage to laboratory, testing, rate of positivity, treatment initiation, etc.
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.
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.
It is helpful for National TB Programs (NTPs) to understand the burden of drug resistance and respond accordingly to initiate people diagnosed with DR-TB on appropriate treatment. The data are valuable for planning laboratory equipment and supplies as well as drug logistics and supervision.
This indicator flows from the Core indicator of bacteriologic confirmation among people with pulmonary TB and complements the Core Plus indicators on people with new and relapse pulmonary TB who have DST results. This indicator can be used to track progress and investment in coverage of testing for drug resistance. This is helpful to monitor performance on drug resistance testing for early detection of DR-TB among people with previously treated (including relapses) pulmonary TB and timely initiation for care and treatment. Based on availability of data this can be plotted as a graph, with the number of previously treated (including relapses) which is pulm_labconf_ret and how many were tested for rifampicin resistance.
Indicator Visualizations
We do not currently have an indicator visualization for this indicator. Please check back later.