املركــز الوطين ملكافحة األمراض National Centre for Disease Control إدارة مكافحة الدرن واألمخاج التنفسية واجلذام
MONITORING AND EVALUATION INDICATORS OF NATIONAL TUBERCULOSIS CONTROL PROGRAMS
MONITORING AND EVALUATION INDICATORS OF NATIONAL TUBERCULOSIS CONTROL PROGRAMS
MONITORING AND EVALUATION:is the collective use of social science and epidemiological research methods to assess, and eventually improve, the implementation of programs, or components of programs.5 The overall purpose of M&E is to measure program effectiveness, identify problem areas, gather lessons learned, and improve overall performance. M&E activities are used to assess progress towards specific objectives and address weaknesses in program design. A number of different methods or approaches are available for tracking changes and measuring program performance: monitoring, evaluation (i.e., process, outcome, and impact), and surveillance. 2
1. Indicators for Global Reporting The indicators described in this section are based on data reported by NTPs. Data are used to monitor progress in DOTS expansion and achievement at national and global levels of the WHO targets for TB control: treatment success of at least 85% and case detection rate of at least 70%.
Indicators :
TB case detection rate. Treatment success rate. DOTS coverage. Surveillance of multidrug-resistant TB. HIV seroprevalence among TB patients.
1-TB case detection rate :-
The percentage of TB cases detected (diagnosed and reported to the national health authority) among the total number of TB cases estimated to occur countrywide each year.
2-Treatment success rate :-
The percentage of a cohort of TB cases registered in a specified period that successfully completed treatment, whether with bacteriologic evidence of success (“cured”) or without (“treatment completed”).
3-DOTS coverage :-
Percentage of the population living in the area of basic management units 3
implementing the DOTS strategy.
4-Surveillance of multidrug-resistant TB:-
The national TB control program assesses the prevalence of multidrug-resistant TB at least once within a 5-year period. This is a yes/no indicator.
5-HIV seroprevalence among TB patients:-
Number of all newly registered TB patients who are HIV positive, expressed as a percentage of all registered TB patients.
2. Indicators for Program Outcomes
The indicators in this section are routinely calculated by TB control programs at district, regional, and national levels, and they are based on data from the TB register and quarterly reports on TB case registration, smear conversion, and treatment outcomes. They are used to monitor progress towards achievement of the national targets for case detection and treatment outcomes and to monitor program quality and effectiveness.
Indicators :
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Case notification rate. Case notification rate—new smear-positive pulmonary TB cases. New pulmonary TB cases with no smear result. New adult smear-positive cases. Retreatment TB cases. New extrapulmonary TB cases. New TB cases with no smear conversion result. Sputum conversion rate at the end of the initial phase of treatment. Cure rate.
Treatment completion rate. Death rate. Treatment failure rate. Default rate. Transfer-out rate. Retreatment failure rate (chronic TB rate).
1 Case notification rate:The number of TB cases reported to the NTP per year per 100,000 population. 2 Case notification rate—new smear-positive pulmonary TB cases:The number of new smear-positive pulmonary TB cases reported to the NTP per year per 100,000 population. 3 New pulmonary TB cases with no smear result :The percentage of new pulmonary cases registered that do not have results of sputum smear examinations on diagnosis. 4 New adult smear-positive cases:The percentage of new adult smear-positive TB cases out of all adult pulmonary TB cases. 5 Retreatment TB cases:The percentage of TB cases classified as retreatment in the past year. 6 New extrapulmonary TB cases:The percentage of TB cases with site of disease defined as extrapulmonary in the past year. 7 New TB cases with no smear conversion result:The percentage of new smear-positive pulmonary TB cases registered in a specified period that were not examined by sputum microscopy at the end of the initial phase of treatment. 5
8 Sputum conversion rate at the end of the initial phase of treatment:The percentage of new smear-positive pulmonary TB cases registered in a specified period that converted to smear negative at the end of the initial phase of treatment. The initial phase of treatment may be 2 to 3 months depending on national guidelines. 9 Cure rate:The percentage of TB cases that were registered in a specified period and were cured. All TB cases recorded as cured must have a negative sputum smear result recorded during the last month of treatment and on at least one previous occasion during treatment. 10 Treatment completion rate:The percentage of TB cases registered in a specified period that completed treatment. 11 Death rate:The percentage of TB cases registered in a specified period that died during treatment, irrespective of cause.
12 Treatment failure rate:-
The percentage of TB cases registered in a specified period that were treatment failures. 13 Default rate:The percentage of TB cases registered in a specified period that interrupted treatment for more than 2 consecutive months. 14 Transfer-out rate:The percentage of TB cases registered in a specified period that were transferred to another basic management unit from which there is no treatment outcome information. 15 Retreatment failure rate (chronic TB rate):Percentage of retreatment (treatment-after-failure, treatment-after-relapse, and 6
treatment-after-default) sputum smear-positive pulmonary cases registered during a specified period that are smear positive at the end of the retreatment regimen.
3. Diagnosis and Laboratories Indicators:-
• TB microscopy coverage. • TB microscopy units with adequate workloads. • TB suspects who are smear positive.
1 - TB microscopy coverage:-
1. Percentage of all TB microscopy units that cover a population size within the recommended range of 50,000 to 150,000 inhabitants. 2. Average population per TB microscopy unit.
2 - TB microscopy units with adequate workloads:-
Percentage of all TB microscopy units with an average daily staff workload within a recommended range (2 to 20 slides per day per microscopist).
3 - TB suspects who are smear positive:-
Percentage of TB suspects who are found to be smear positive.
M &E INDICATORS OF WHO .
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املركــز الوطين ملكافحة األمراض National Centre for Disease Control إدارة مكافحة الدرن واألمخاج التنفسية واجلذام