References in the content below refer to the PBMEF Guide.
Definitions
Percentage of new and relapse TB cases (bacteriologically confirmed or clinically diagnosed, pulmonary or extrapulmonary) who were notified in a specified period that were cured or treatment completed, among the total new and relapse TB cases (bacteriologically confirmed or clinically diagnosed, pulmonary or extrapulmonary), notified to the national health authorities during the same reporting period.
Treatment outcomes are defined by the time period of enrollment on treatment; e.g., “2018 cases successfully treated” reflect those who were enrolled on treatment in 2018, even though treatment may have extended into 2019. For this reason, reports of treatment outcome data lag by one year.
Calculation: (Numerator/Denominator) x 100
Numerator
Denominator
Ref # |
SS-1
|
Tier Level |
Core Indicator
|
Category |
Cure
|
Type |
Core Outcome
|
Unit of Measure |
Percent of cases
|
Data Type |
Percentage
|
Disaggregations |
Age
Gender
Subnational
|
Reporting Level |
National
|
Reporting Frequency |
Annually
|
This indicator is reported by national TB program (NTP) official records. Quarterly report on TB treatment outcomes in the basic management unit and Form 07: Combined annual outcomes report for basic TB and for RR-/multidrug-resistant (MDR)-TB.
This standard World Health Organization (WHO) indicator can also be calculated using the WHO database. The variable for the numerator is newrel_succ and the denominator is newrel_coh.
Treatment success is an important indicator of TB disease control and service quality, as it measures the NTP’s capacity to retain patients through a complete course of treatment with a favorable outcome. This indicator measures the successful treatment of a cohort of infectious cases of TB, which is essential to prevent the spread of the infection. The treatment success rate allows countries to monitor progress towards meeting global and national targets and to determine whether more resources are required to improve treatment outcomes by reducing death, loss to follow-up (LTFU), and the proportion of cases with an outcome that is not evaluated.
The latest global treatment outcome data from 2018 show success rates of 85% for TB and 76% for HIV-associated TB, short of the End TB Strategy target of 90% by 2025. Detecting and successfully treating a large proportion of TB cases should have an immediate impact on TB prevalence and mortality. Low treatment success rates may indicate problems with the treatment regimens being administered, poor treatment management, adverse side effects, or comorbidities leading to death or LTFU. An understanding of why treatment success may be low is important to be able to implement solutions for improving patient care.
TB treatment success rate can be analyzed as a trend showing whether treatment success is improving or getting worse over time, and to compare the rate to national and global treatment success rate targets. A comparison of TB patients initiated on treatment and successfully completing treatment using a cascade of care will highlight the gap in the cascade where some patients were lost. (See Appendix 2 for a more detailed drug-susceptible [DS]-TB pathway and cascade of care.) The gap between treatment initiation and treatment success can be further broken down to understand why patients were unsuccessful with treatment (e.g., death, LTFU, treatment failure, or unknown outcomes). Treatment success rates can also be compared between DS and drug-resistant TB (DR-TB) and TB/HIV