TB Module Guide


The Health Services Report captures tuberculosis (TB) service delivery on a monthly basis. All service data are disaggregated by Channel: Franchise Facility, Service Delivery Partner, or PSI Direct Service Provision. For franchise facilities and service delivery partners, only services that meet PSI’s criteria for service delivery through partners can be reported. For detailed definitions of these channels and channel types, please click here: https://helppsi.freshdesk.com/support/solutions/articles/14000014984-common-data-element-definitions


Why collect these data?

The TB module tables request data from Global Fund TB indicators as well as standard national TB recording and reporting forms. This data is useful for a variety of programmatic and reporting applications:

 

Internally , these data will provide important information about global trends, informing quality assurance measures and facilitating identification of platform-to-platform technical assistance opportunities for programmatic improvement. For example, programmatic trends help us identify new problems and areas that need greater attention and support.

 

Externally , these data will allow PSI to leverage its network to contribute to global discussions about TB service delivery, particularly in the private sector. PSI is often asked to share global data related to key TB-related outcomes, including treatment success rates and case registration, with particular interest in the yield of bacteriologically positive cases. Importantly, combined with screening data, these data can facilitate calculation of “number needed to screen for one case of TB detected” in PSI programs. In addition, with a global focus on strengthening public-private partnerships to reduce the number of new TB cases, our channel information is critical to understanding the role of the private sector in TB care and control.

 

Impact Estimation  (e.g. DALYs averted): In each table, we have noted where data will be used to estimate impact.



The table below outlines the module’s data tables and their corresponding data elements:


Section 1: Screening and diagnosis

Data Elements

Table 1: Clients screened and diagnosed with TB TB
Clients screened for TB

Clients diagnosed with TB (all forms)

Section 2: Treatment

Data Elements

Table 1: Treatment outcomes
Clients cured

Individuals completing treatment (no final sputum examination)


Each table and data element are described in further detail below.


Section 1: Screening

Data Elements

Table 1: Clients screened for TB
Clients screened for TB

Clients diagnosed with TB (all forms)



Data Element: Clients screened for TB by channel
Purpose: 
This data element is measuring the total number of clients screened for active TB
Precise Definitions:
 
Screening is the systematic identification of people with presumptive active TB. Screening typically involves interviewing clients about possible TB symptoms, but may also include chest x-ray. Active TB symptoms may include coughing up blood, fever, night sweats, or chest pain. The WHO has a number of recommended screening algorithms for adults and children. For more information see the WHO report on Systematic Screening for Active Tuberculosis). Screening does not yield a diagnosis; it helps determine if the client will need to undergo diagnostic services.
 
For a detailed definition of “channel” see the common data elements definition page.
Unit of Measure: Number of clients screened for TB
Disaggregated by:
Channel (franchise facilities, PSI direct service provision, service delivery partner)
Justification/Management Utility:
TB screening is the cornerstone of any effort to increase TB case detection. Gven the global focus on private sector engagement for TB care, disaggregation by channel will provide important information about the contribution of franchise facilities to TB screening goals. Finally, these data will allow PSI to assess the “number needed to screen” to yield one case of TB in various channels.

The WHO doesn’t recommend general population-based screening for TB as it’s not cost-effective, and hasn’t demonstrated population level impact. Screening programs should focus on prioritized populations which include contacts of known TB patients, PLHIV, prisoners, people in very high burden settings, and people who work in occupations where they have exposure to silica.



Data Element: Clients diagnosed with TB (all forms) by channel
Purpose: This data element is measuring the total number of clients diagnosed with TB
Precise Definitions:
 
This data element captures clients who were bacteriologically confirmed AND those who were clinically diagnosed. 
 
This data element only includes patients diagnosed within PSI’s network (where samples were collected by PSI for analysis).
 
Diagnosis of active TB can be confirmed microbiologically using a variety of methods, including identification of AFB using sputum smear microscopy, through culture, or through PCR-based methods such as Xpert. There are some other options for specialized settings/patients. An overview can be found here: http://www.who.int/tb/publications/tbDiagnostics_factsheet.pdf?ua=1

TB can also be confirmed based on a clinical diagnosis.
 
For a detailed definition of “channel” see the common data elements definition page.
Unit of Measure:
Clients with a bacteriologically confirmed diagnosis of TB
Disaggregated by:
Channel (franchise facilities, PSI direct service provision, service delivery partner)
Justification/Management Utility:
These data will contribute to important global and regional conversations about the utility of active case finding.




Section 2: Treatment

Data Elements

Table 1: Treatment Outcomes
Clients cured

Individuals completing treatment (no final sputum examination)


Data Element: Clients cured, by channel
Purpose: 
This data element is measuring the total number of individuals cured of drug susceptible TB
Precise Definitions:
 
Cured: individuals who had bacteriologically confirmed drug susceptible TB before treatment and who were sputum smear negative at the last month of treatment and on at least one previous occasion.
Clients suspected of multidrug resistant TB should not be included in this data element.
 
For a detailed definition of “channel” see the common data elements definition page
Unit of Measure: Number of clients cured
Disaggregated by:
Channel (franchise facilities, PSI direct service provision, service delivery partner)
Justification/Management Utility:
Recording treatment outcome data is standard best practice in TB care and control. These programmatic data provide key information on the quality of treatment programs. Data on these outcomes are critical because incomplete or unsuccessful treatment can increase TB morbidity and mortality, as well as increase the emergence of MDR-TB. These data will be used to inform quality improvement efforts and will also inform the calculation of DALYs averted.



Data Element:
Individuals completing treatment (no final sputum examination), by channel
Purpose: 
This data element is measuring the total number of individuals completing treatment for TB
Precise Definitions:
 
Completing treatment: individuals who completed the course of treatment but for whom smear examination results are not complete enough to classify the individuals are "cured". This outcome includes individuals for whom the final smear examination was not done.
 
 
For a detailed definition of “channel” see the common data elements definition page
Unit of Measure:
Number of clients completing treatment
Disaggregated by:
Channel (franchise facilities, PSI direct service provision, service delivery partner)
Justification/Management Utility:
Recording treatment outcome data is standard best practice in TB care and control. These programmatic data provide key information on the quality of treatment programs. Data on these outcomes are critical because incomplete or unsuccessful treatment can increase TB morbidity and mortality. These data will be used to inform the calculation of DALYs averted.