References in the content below refer to the PBMEF Guide.
Definitions
Number of people who were initiated on TB preventive treatment (TPT). This includes: (1) household and other close contacts of people with notified, bacteriologically confirmed pulmonary TB (adults, adolescents, and children <5 years), and (2) people living with HIV (PLHIV).
Household contact: a person who shared the same enclosed living space as the index case for one or more nights or for frequent or extended daytime periods during the 3 months before the initiation of current treatment.
“Other” close contacts will be assessed by clinical judgment or experience. In general, this may include someone who may not live in the same house as the index patient but spends considerable time there or spent time elsewhere when the index case was present. It may also be someone who the index case may have spent time in close contact in other settings such as in school or in the workplace.
Numerator
Denominator
Ref # |
TPT_ENROLL
(Previously PT-1) |
Tier Level |
Core Indicator
|
Category |
Prevent
|
Type |
Core Outcome
|
Unit of Measure |
Number of people initiated on TPT
|
Data Type |
Integer
|
Disaggregations |
Age (0–4, 5–14, 15+)
Sex
Risk group (contacts, PLHIV)
|
Reporting Level |
All Core PBMEF indicators should be reported at the national level; data may also be reported 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. Performance plans and reports (PPRs) reporting for this indicator are based on calendar year (CY) periodicity to reflect national level attainment and align with the USAID congressional reporting requirements.
|
National TB Program (NTP) official records report on this indicator. Some NTPs may include TPT initiation on the quarterly report on TB case registration or quarterly report on TB treatment outcomes, but this may vary country to country. In other settings, this data is available at the individual (case-based) levels through the NTP for contacts and the HIV/AIDS program for PLHIV.
This standard WHO indicator can also be calculated using the WHO database variable: newinc_con_prevtx plus hiv_ipt_reg_all.
Prevention of new TB infections (TBIs) and of progression from TBI to active disease is critical to reduce TB morbidity and mortality, and to achieve the End TB Strategy targets set for 2030 and 2035. This indicator, when measured over time, provides information on the trends in TPT scale-up and helps assess progress toward United Nations High-Level Meeting (UNHLM) targets. Additionally, the USAID TB strategy (2023-2030) has set a target to provide TPT to 30,000,000 contacts (excluding PLHIV) by 2030.
TPT initiation data will help NTP managers and other stakeholders monitor TB prevention efforts among people who are exposed to TB disease and are at risk of developing TBI and progressing to TB disease. Interventions to scale up TPT to all people at risk will prevent the development of active TB disease, and thus, reduce transmission at the community level. This indicator will track the extent to which programs are achieving high TPT initiation and are likely to be reducing this source of TB burden. TPT initiation levels will also indicate the success of a country’s implementation of the TPT strategy and robustness of programmatic management of TPT.
A trend analysis of this indicator can track progress over time as TPT interventions scale up. A cascade of care can also highlight the gaps between contact investigations, identifying individuals who are eligible for TPT and ensuring those who are eligible are initiated on TPT. TPT initiations can further be broken down to understand what percent of the people initiated on TPT is made up of PLHIV, contacts under 5 years of age, and contacts 5 years of age and up for reporting against UNHLM targets.
More information on calculating the number of people eligible for TPT can be found in the WHO Operational Handbook on Tuberculosis: Module 1: Prevention: Tuberculosis Preventive Treatment https://www.who.int/publications/i/item/9789240002906.