Monitoring, Evaluation, and Reporting (MER) Guidance (v.2.3): TB and HIV

Transcription

1 Monitoring, Evaluation, and Reporting (MER) Guidance (v.2.3): TB and HIV Sean Cavanaugh, Senior TB Technical Advisor Office of the U.S. Global AIDS Coordinator & Health Diplomacy August 2018

2 Video Outline 1) Section 1: Overview of the technical area. 2) Section 2: Indicator changes in MER ) Section 3: Review of definitions and how to review this data. 4) Section 4: Overview of guiding narrative questions 5) Section 5: Additional Resources and Acknowledgments Please note: FY19 DATIM data entry screens are currently in development. Additional training materials on data entry requirements are forthcoming. 2

3 Section 1: Overview of the technical area

4 Why is this topic important? 4

5 How does TB fit into ? 95% 95% 95% ** Are persons with TB symptoms being identified and tested for HIV? 5

6 Overview of TB/HIV Indicators TB_STAT Num. TB_STAT Den. & TB_ART Num. Program Area Group Indicator Name Numerator or Denominator Definition Knowing HIV Status TB_STAT Numerator # of new and relapsed TB cases with documented HIV status, during the reporting period Denominator total # of new and relapsed TB cases, during the reporting period On ART TB_ART Numerator # of TB cases with documented HIV-positive status who start or continue ART during the reporting period 6

7 Overview of TB/HIV Indicators TX_TB Num. TX_TB Den. & TB_PREV Num. TB_PREV Den. Program Area Group Indicator Name Numerator or Denominator Definition On ART TX_TB Numerator # of ART patients who were started on TB treatment during the semiannual reporting period Denominator # of ART patients who were screened for TB at least once during the semiannual reporting period Prevention TB_PREV Numerator # of ART patients who completed a course of TB preventive therapy during the reporting period (for continuous IPT programs, this includes only the patients who have completed the first 6 months of isoniazid preventive therapy in the reporting period) Denominator # of ART patients who are expected to complete a course of TB preventive therapy during the reporting period (for programs using continuous IPT, this includes only the patients who are scheduled to complete the first 6 months of therapy) 7

8 TB/HIV Patient Flow 8

9 Section 2: Indicator changes in MER changes

10 What s Changed? 1 We will reduce data entry redundancies in FY19. In the DATIM data entry screens, data entered under the TB_STAT indicator will also automatically populate under corresponding fields for HTS_TST. TB_STAT Newly tested positives New negatives autopopulate HTS_TST: TB modality Newly tested positives New negatives Rationale for this change: This will 1) reduce data entry burden since data entry clerks only enter data in one place instead of in two places and 2) ensure data quality and consistency. 10

11 What s Changed? 2 TB_STAT Den. TB_STAT Num. & TB_ART Num. MER 2.2 Reporting frequency Semi-annual MER 2.3 Reporting frequency Quarterly Rationale: This change will align reporting frequencies for TB_STAT and HTS_TST. 11

12 What s Changed? 3a TB_STAT Den. MER 2.2 Disaggregates: coarse age/sex F: <15 ; 15+ ; M: <15 ; or 15+ MER 2.3 Disaggregates: fine age/sex F: unknown age, <1 ; 1-4 ; 5-9 ; ; ; ; ; ; ; ; ; 50+ M: unknown age, <1 ; 1-4 ; 5-9 ; ; ; ; ; ; ; ; ; or 50+ Rationale: This change will align age/sex categories with TB_ART Numerator. 12

13 What s Changed? 3b TB_STAT Num. MER 2.2 Disaggregates: age/sex/result Known positives ; Newly tested positives ; or New negatives ; and MER 2.3 Disaggregates: age/sex/result Known positives ; Newly tested positives ; or New negatives ; and F: <15 ; 15+ ; M: <15 ; or 15+ F: <1 ; 1-4 ; 5-9 ; ; ; ; ; ; ; ; ; 50+ M: <1 ; 1-4 ; 5-9 ; ; ; ; ; ; ; ; ; or 50+ Rationale: This change will align age/sex categories with TB_ART Numerator. 13

14 What s changed? 4 TB_ART Num. MER 2.2 Disaggregates: ART Status Age/sex MER 2.3 Disaggregates: Age/sex by ART Status 14

15 What s changed? 5 TX_TB Num. MER 2.2 Disaggregates: ART Status Age/sex MER 2.3 Disaggregates: Age/sex by ART Status 15

16 What s changed? 6 TX_TB Den.: MER 2.2 In the FY18 data entry screens for TX_TB Denominator, start of ART and screen results are collected separately from age/sex. 16

17 What s Changed? TX_TB denominator disaggregates will be age/sex by start of ART by screen result TX_TB Den.: MER

18 What s changed? 7 TX_TB Den. MER 2.2 Disaggregates: specimen sent ; diagnostic test MER 2.3 Disaggregates: specimen sent ; diagnostic test ; pos. results returned Disaggregated by positive result returned Number of ART patients who had a positive result returned for bacterial diagnosis of active TB disease 18

19 What s changed? 8 TB_PREV Den. & TB_PREV Num. MER 2.2 Disaggregates: Type of TB Preventive Therapy by ART start ; Age/sex MER 2.3 Disaggregates: Type of TB Preventive Therapy by ART start by age/sex 19

20 TB/HIV Indicators: MER 2.2 to TB_STAT* will autopopulate HTS_TST TB modality 2 TB_STAT, TB_ART will be quarterly TB_STAT will have fine age bands/sex TB_ART Num. will have age/sex by ART Status TX_TB Num. will have age/sex by ART Status TX_TB. Den. will have age/sex by start of ART by screen result TX_TB. Den. new disagg. of positive diagnostic test returned TB_PREV will have age/sex by Type of TB Preventive Therapy by ART start *TB_STAT disaggs. of newly tested HIV-positive and newly tested HIV-negative. 20

21 Section 3: Review of Definitions and How to Review this Data

22 Numerator, Denominator, and Disaggregations by Indicator: MER 2.3 TB_STAT Den. reported quarterly at facilities 22

23 Numerator, Denominator, and Disaggregations by Indicator: MER 2.3 TB_STAT Num. reported quarterly at facilities 23

24 Numerator, Denominator, and Disaggregations by Indicator: MER 2.3 TB_ART Num. reported quarterly at facilities 24

25 How to Review and Count this Data TB_STAT Num. TB_STAT Den. TB_ART Num. % of TB cases who know their HIV status = TB_STAT Num. TB_STAT Den. % of HIVpositive TB cases who are on ART = TB_ART Num. TB_STAT_POS Review % coverage by geographic unit (OU to site), partner, agency percent coverage should be 100% TB_STAT Den., TB_STAT Num., and TB_ART Num. should be summed over quarters 25

26 Numerator, Denominator, and Disaggregations by Indicator: MER 2.3 TX_TB Den. Reported semiannually at facilities 26

27 Numerator, Denominator, and Disaggregations by Indicator: MER 2.3 TX_TB Num. Reported semi-annually at facilities 27

28 Numerator, Denominator, and Disaggregations by Indicator: MER 2.3 TB_PREV Den. & TB_PREV Num. Reported semi-annually at facilities Den. and Num. have the same disaggregates 28

29 How to Review this Data How to review TX_TB and TB_PREV? All ART patients should be routinely screened for TB All ART patients who are screened for TB, should have a negative or positive screening result recorded If ART patients screen negative for TB and they are clinically eligible, they should start on TPT 29

30 How to Count TX_TB and TB_PREV The TX_TB denominator should not be summed over semiannual time periods since it is a snapshot indicator that captures a clinical event (screening) and not unique patients. Note that TX_TB Numerator could be summed across semiannual time periods to conclude the # of ART patients who were started on TB tx. during the fiscal year, for example. 30

31 Section 4: Overview of guiding narrative questions

32 Guiding Narrative questions TB_STAT TB_ART Num. 32

33 Guiding Narrative questions TX_TB TB_PREV 33

34 Section 5: Additional Resources and Acknowledgments

35 Additional Resources Global Tuberculosis Report, 2017; WHO: Latent TB Infection : Updated and consolidated guidelines for programmatic management; WHO: A guide to monitoring and evaluation for collaborative TB/HIV activities, WHO: Monitoring an Evaluation Framework; Global Fund: 35

36 Acknowledgments USAID Catherine Nichols Sevim Ahmedov Paul Pierre Charlotte Colvin CDC: Ishani Pathmanathan Diya Surie Hannah Kirking Adam McNeil 36

37 Thank you