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Treatment Success Rate among PLHIV

References in the content below refer to the PBMEF Guide.

Definitions

Percent of people living with HIV (PLHIV) with new and relapse TB among PLHIV (bacteriologically confirmed or clinically diagnosed, pulmonary or extrapulmonary) who were notified in a specified period that were cured or treatment completed, among the total number of people with new and relapse TB (bacteriologically confirmed or clinically diagnosed, pulmonary or extrapulmonary) who were initiated on treatment during the same reporting period (excluding those moved to RR-TB treatment cohort).

Treatment outcomes are defined by the time of initiation on treatment; e.g., “2018 cases successfully treated” reflect those who were initiated 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

Number of PLHIV with new and relapse TB (bacteriologically confirmed or clinically diagnosed, pulmonary or extrapulmonary), who were registered in a specified period that were cured or treatment completed

Denominator

Number of PLHIV with new and relapse TB (bacteriologically confirmed or clinically diagnosed, pulmonary or extrapulmonary) who initiated treatment in the same period
Ref #
PLHIV_TSR
Tier Level
National Level Indicators
Category
Cure
Type
Outcome
Unit of Measure
Percent of PLHIV
Data Type
Percentage
Disaggregations
Age (<15, 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 or monthly basis is recommended.

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.

Treatment success is an important indicator of the quality of TB services, as it measures the National TB Program’s (NTP) capacity to support patients through a complete course of treatment with a favorable outcome. Successful treatment requires a stable supply of TB medications, management of side effects and various efforts to support people with TB so they can complete the full course of treatment. This indicator measures the successful treatment of a cohort of people with TB, which is essential to prevent the spread of the infection. The treatment success rate (TSR) 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 percent of people with an outcome that is not evaluated.

Detecting and successfully treating a large percent of people with TB should have an immediate impact on TB prevalence and mortality. Low TSRs 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 TSR can be analyzed as a trend showing whether treatment success is stable, improving or decreasing over time, and to compare the rate to national and global treatment success rate targets. A comparison of people with TB who initiated treatment and successfully completed treatment using a cascade of care will highlight the gap in the cascade where some people were lost during the treatment phase. The gap between treatment initiation and treatment success can be further broken down to understand why people were unsuccessful with treatment (e.g., death, LTFU, treatment failure, or unknown outcomes). TSRs can also be compared between drug- sensitive (DS) and drug-resistant (DR) TB and TB/HIV, but differences in treatment outcomes among these cohorts should be interpreted with caution; differences in TB epidemiology at the national level, resistance profile, HIV program context and other factors should be considered.

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