UGANDA NATIONAL TUBERCULOSIS AND LEPROSY CONTROL PROGRAMME
|
|
- Myron Burke
- 6 years ago
- Views:
Transcription
1 MINISTRY OF HEALTH UGANDA TIOL TUBERCULOSIS AND LEPROSY CONTROL PROGRAMME Revised Strategic Plan 2015/ /20 Monitoring and Evaluation Plan Narrative of the Operational, Budget and Technical Assistance Plan June 2017
2 TABLE OF CONTENTS 1. Introduction 3 Overview of the NTLP M&E System 3 Data Collection Methods 4 2. Monitoring and Evaluation Plan 5 M&E Plan Objectives 5 s by objective and strategic intervention 6 definitions Narrative of the Operational, Budget and Technical Assistance Plan 42 Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 2
3 1. Introduction Tuberculosis (TB) and leprosy continue to threaten public health in Uganda. The Ugandan Ministry of Health addresses TB and leprosy response in its Health Sector Development Plan II 2015/ /20. TB is the fifth most common cause of death in Uganda, potentially resulting in adverse socioeconomic impacts as the majority of notified patients/cases are in their years of greatest economic productivity. Leprosy is still endemic in Uganda. A total of 1,003 new cases were reported to NTLP during the last 3 years. In 2013, over 60% of new cases were concentrated in 10 of 116 districts. Recent advances in the fight against TB and leprosy, findings from the 2014/15 National TB Prevalence Survey, and revisions to the Uganda Xpert MTB/Rif policy and urban DOTS model necessitated revisions to the current NTLP National Strategic Plan (NSP) 2015/16 to 2019/20. Accordingly, the NTLP revised the monitoring and evaluation (M&E) plan to reflect changes in the strategic plan 2015/ /20. Overview of the NTLP M&E System The goal of the current M&E plan is to enable evidence-based decision-making to improve performance. Based on this, the M&E plan sets out to: Guide the process of collecting, analysing and presenting specific data, based on predefined indicators; Describe and guide the process of measuring progress towards NTLP targets; Ensure the set of indicators, tools and M&E systems are adapted to monitor the quality and coverage of service delivery, both at health facility and community levels; Ensure effective implementation of the M&E plan by regularly monitoring and periodically evaluating the plan itself; and Provide a framework for implementation of NTLP monitoring and evaluation activities. The WHO and MOH joint review of the NTLP conducted in September 2013 revealed that NTLP are not channelled through the Electronic Health Information System, Uganda s District Health Information System 2 (DHIS2). Managed by the MOH Division of Health Information, the DHIS2 has a user-friendly interface and 100% health facility reporting coverage for the public and private non-for-profit sectors. Although health facilities are reporting some TB indicators through DHIS2, these are often incomplete and inaccurate hence not analysed or used. More so, the TB indicators have not been completely integrated into the DHIS2. The only indicators in DHIS 2 are; proportion of PLHIV screened for active TB; proportion of PLHIV diagnosed with TB and proportion of PLHIV diagnosed with TB who are started on TB treatment. A disadvantage of the DHIS2 is that it aggregates data, preventing individual data for cohort analysis. The NTLP is still investigating how to integrate TB data collection and management in the DHIS2 while providing for the NTLP s data needs (List of the proposed indicators to be included in DHIS2 is in Table 4). Table 1 provides an overview of the current NTLP and data sources. Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 3
4 Table 1: Description of NTLP and data sources. Data Source Relevant Time of Responsibility Period Collection National TB Every 5-10 years NTLP & Partners Prevalence Survey NTP and Previous year ly NTLP, WHO WHO Global Tuberculosis Report NTP quarterly Previous quarter NTLP EQA quarterly Previous quarter National TB Reference Laboratory (NTRL) TB services in prisons Previous quarter Prison Health Service Supervisory visit Previous quarter for selected districts NTLP, NTRL Data Collection Methods The routine reporting system follows these lines of reporting: Diagnostic and Treatment Units (DTU) report to the district. Districts report to regions. Regions report to the central NTLP office. Currently, the M&E unit at the central NTLP office consists of an M&E specialist, epidemiologist, data manager and data analyst. The M&E specialist and data manager, funded through the Global Fund to Fight AIDS, TB, and Malaria (Global Fund), collate and analyse data from the districts. Partners provide additional staff to support the NTLP s efforts to improve recording, reporting and use of TB data at all levels of the health system. As recommended in the Program Review Report (September 2013), the NTLP is developing standard operating procedures (SOPs) to guide health facilities as well as district, regional and national level officers to improve data completeness, quality and use for performance improvement at different levels. In addition, quarterly review meetings help to improve the accuracy of data and timeliness of reporting. During regional quarterly review meetings, district supervisors (District TB and Leprosy Supervisors (DTLS), District laboratory Focal Persons (DLFP) verify outcomes of TB patients transferred from one district to another within the region and Regional TB and Leprosy Focal Persons (RTLPs) validate the before submission to the national level. The district local governments have recruited biostatisticians to improve collection, analysis and use of health information at the district level. The biostatisticians will support the district TB supervisors to improve timely reporting through the DHIS2 and analysis of TB data for performance improvement. Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 4
5 2. Monitoring and Evaluation Plan This M&E plan aims to monitor the TB and leprosy control, implementation of the NSP 2015/ /20, and investments to improve M&E for TB and leprosy in Uganda. M&E Plan Objectives Objectives of the M&E component of the NSP The NTLP National Strategic Plan prioritizes M&E in its fourth objective to establish and strengthen systems for effective management of tuberculosis & leprosy services to meet the NSP targets. Broad Objective To establish and strengthen M&E systems for tracking performance and measuring outcomes and impacts to guide decision-making Specific Objectives 1. Improve recording and reporting, data management and analytical capacity at national and sub-national levels 2. Develop an electronic TB monitoring and evaluation system (etb) 3. Strengthen TB supervision at all levels Under the same objective, the National Strategic Plan calls for implementation of a research agenda through collaboration of NTLP and the Uganda TB research community. This intervention includes a drug resistant survey and inventory studies to assess under-reporting, to be conducted in the 2015/ /20 period. The NSP M&E intervention aims to strengthen data management and quality through by regularly assessing data quality and developing guidelines and standard operating procedures. To improve timely availability of data, NTLP plans to develop an electronic system that will capture more data as well, for example of key populations, by of this NSP. To support these developments, NTLP will strengthen supervision to all levels. Table 2: Main activities under the M&E strategic intervention Start date M/Year End date M/Year Target by 2019/20 Total investment Objective 4: To strengthen systems for effective management of tuberculosis & leprosy services to meet the NSP targets Strategic Intervention 4.7. To strengthen M&E systems for tracking performance and measuring outcomes and impacts to guide decision-making Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 5
6 Improve recording and reporting, data management and analytical capacity at national and sub-national levels Develop electronic TB monitoring and evaluation system (etb) Strengthen TB supervision at all levels. Apr-16 Oct-15 Jul-15 Jun-20 Jun-20 Jun Percentage of districts submitting timely complete according to national guidelines (factor = timeliness x completeness) >90% $5,280,167 $649,060 $1,089,382 Total Investment M & E $7,018,608 s by objective and strategic intervention Figure 1 illustrates the monitoring framework to track progress of TB control and NSP implementation in Uganda. Figure 1. TB monitoring framework Through a consultative process, stakeholders set initial targets in June - July The NTLP modified these targets during revisions to the National Strategic Plan, according to 2014/15 National TB Prevalence Survey results and revisions to the Uganda Xpert MTB/Rif policy and urban DOTS model and recommendations from local, international and global technical partners. Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 6
7 Goal: To reduce TB incidence by 5%, i.e. from 234 cases of TB (all forms) per 100,000 population in 2015 to 222/100,000 by 2020 Year Value 2015/ / / / /20 source 1.0 Incidence rate Impact Uganda national TB survey Objective 1: To increase case notification rate of incident TB from 119/100,000 in 2015/16 to 156/100,000 in 2019/20 and to increase treatment success rate among notified incident cases from 74% in 2015/16 to 85% in 2019/ Notification rate of incident TB cases per 100,000 population Outcome (42,320) 119 (42,320) 115 (42,320) 128 (48,245) 141 (54,999) 156 (62,699) TB annual & quarterly 1.2. Treatment success rate for incident TB cases (Denominator) Outcome 2015 cohort 74% (42,320) 74% (42,320) 78% (42,320) 82% (42,320) 85% (48,245) 85% (54,699) TB quarterly 1.3. Cure rate among new PBC TB cases Outcome 2015 cohort 51% 51% 56% 60% 65% 75% TB quarterly 1.4. Treatment success rate among all forms of TB Outcome 2015 cohort 79% 79% 80% 82% 84% 85% TB quarterly Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 7
8 Year Value 2015/ / / / /20 source 1.5. Case fatality rate among all forms of TB Outcome 2015 cohort <5% <5% <5% <5% <5% <5% TB quarterly 1.6. Loss to follow-up rate among all forms of TB Outcome 2015 cohort 12% 12% <5% <5% <5% <5% TB quarterly Strategic intervention 1.1: Increase the capacity of health workers to screen and diagnose TB, with a focus on childhood, extra-pulmonary and clinically diagnosed TB Percentage of children (0-14 years) among all forms of incident TB patients notified 7.4% 7.4% 9% 11% 13% Output 2015 (3,132) (3,132) (3,809) (5,307) (7,150) TB 15% quarterly (8,935) Strategic intervention 1.2: Improve access to and use of quality laboratory and radiology services for TB diagnosis and treatment monitoring Number of new pulmonary bacteriologically confirmed patients Output 2015 cohort 25,382 25,382 25,382 28,778 32,807 37,400 TB quarterly notified Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 8
9 Percentage of new and relapse TB patients tested using WHO recommended rapid tests at time of diagnosis Drug susceptibility testing coverage (%) Percentage of labs participating in external quality assurance (EQA) The percentage of high false negative reported in diagnostic and treatment units Output % 21% 26% 36% 46% 56% TB quarterly Output % 25% 31% 41% 51% 61% TB quarterly National and Output % 88% 90% 92% 94% 96% regional quarterly EQA National and Output % 3% < 3% < 2% < 2% < 2% regional quarterly EQA Strategic intervention 1.3: Register and initiate treatment with all diagnosed TB patients, and support their adherence to treatment regimens. Year Value 2015/ / / / /20 source TB treatment coverage in % (Denominator) Output % (83,380) 51% (83,380) 49% (85,958) 55% (87,209) 62% (88,479) 70% (89,310) report Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 9
10 Proportion of all TB patients registered in care who are treated under Directly Observed Therapy (DOT) TB Output % 77% 77% 80% 85% 90% report Strategic intervention 1.4: Empower patients, their families and communities to recognise and refer presumptive TB patients to diagnostic facilities, support treatment adherence and conduct contact tracing Percentage of TB cases (all forms) notified in the VHT diagnostic and treatment units Output Unknown 7% (42,320) 8% (42,320) 9% (48,245) 10% (54,999) 11% (62,699) registers, CSO/CBO who were referred by the village health team/cso Contact investigation coverage Output % 8% 13% 20% 28% 35% Unit TB register Contact investigation coverage among Output % 14% 14% 24% 34% 50% Unit TB register PBC-TB cases Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 10
11 Number of close contacts (<5years) of PTB patients provided IPT Latent TB treatment (IPT) coverage ( <5years contacts of PTB patients) TB Output ,122 2,026 3,937 7,070 quarterly TB Output % 8% 18% 28% 38% 50% quarterly Strategic intervention 1.5: Establish and strengthen facility and community health systems to facilitate referral of presumptive TB patients to diagnostic facilities as well as support treatment adherence and systematic TB screening among contacts (CHEWs, CLFs and VHTs) Proportion of mapped CSOs that are implementing TB control activities Proportion of mapped CSO s reporting using recommended tools Proportion of mapped CSOs trained in TB management Output 2013 Unknown 10% 10% 15% 20% 25% URSB directory CHEWs/ Output 2013 Unknown 10% 10% 20% 35% 50% VHT register NTLP Output 2013 Unknown 10% 10% 60% 65% 70% training Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 11
12 Strategic intervention 1.6: Strengthen TB care and prevention in congregate settings Percentage new prisoners screened for TB (entry screening) Prison Output % 60% 65% 70% 75% 80% health services Number bacteriological confirmed TB in new prisoners Output Prison health services Strategic intervention 1.7: Strengthen and expand public-private mix approaches for TB care and control, in line with the national policy framework Number of private for-private & private not-forprofit health facilities accredited to function as diagnostic and treatment units Output Surveys Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 12
13 Strategic intervention 1.8: Implement an urban TB care and prevention strategy for cities and municipalities Treatment success rate for incident TB cases on first-line drugs in cities and municipalities Output % 87% 88% 89% 90% 90% DHIS 2 cohort Contact investigation coverage in cities & municipalities Output % 28% 40% 50% 60% 70% DHIS Number of close contacts (<5years) of PTB patients provided IPT in cities & municipalities Output DHIS Latent TB treatment (IPT) coverage (<5years contacts of PTB patients) in cities & municipalities Output % 17% 25% 35% 45% 60% DHIS 2 Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 13
14 Objective 2: To strengthen TB/HIV integrated care for co-infected patients and increase ART coverage among TB/HIV co-infected among TB/HIV co-infected patients from 88% in 2015/16 to 95% by 2019/20 Note: These indicators and targets are aligned with the Uganda TB/HIV policy (2013). Year Value 2015/ / / / /20 source 2.1. Percentage of registered incident TB patients coinfected with HIV who started on and/or continued Outcome % (17,088) 88% (17,088) 90% (17,211) 92% (20,022) 94% (22,825) 95% (26,020) TB quarterly anti-retroviral therapy (ART) (Denominator) Strategic intervention 2.1: Strengthen collaboration, coordination and monitoring mechanisms for TB/HIV integration. Year Value 2015/ / / / /20 source Percentage of TB/HIV joint planning meetings Output 2015 Unknown 25% 50% 75% 100% 100% Minutes of held meetings Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 14
15 Strategic intervention 2.2: Scale up implementation of the one-stop model for co-infected TB patients at health facilities. Year Value 2015/ / / / /20 source Percentage of health centres Surveys, (IV and above) providing TB/HIV Output 2015 Unknown 5% 10% 25% 50% 70% supervision, services in an DQA integrated manner Strategic intervention 2.3: Implement TB/HIV interventions to decrease the burden of HIV among patients with presumptive and diagnosed TB Percentage of registered new and relapse TB patients with documented HIV status Percentage of registered HIVpositive TB patients who started on and/or continued co-trimoxazole preventive treatment (CPT) TB Output % (42,320) 97% (42,320) 98% (42,320) 99% (48,245) 100% (54,999) Output % 98% 99% 99% 99% (17,088) (17,088) (17,211) (20,022) (22,825) 100% quarterly (62,699) TB 99% quarterly (26,020) Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 15
16 Strategic intervention 2.4: Support implementation of Intensified Case Finding (ICF) i.e. active TB case finding among people living with HIV and provision of IPT in HIV care clinics Percentage of people living with HIV who were newly enrolled in HIV care and screened for TB Latent TB treatment coverage among newly enrolled people living with HIV Output % 68% 75% 80% 90% 95% HMIS 106a Output 2015 Unknown Unknown 5% 10% 20% 30% HMIS 106a Strategic intervention 2.5: Implement TB infection control (TBIC) practices in all health care facilities, congregate and community settings Number of health workers diagnosed with TB in the last year Percentage of prisoners screened for TB in the last year unit TB register Output 2015 Unknown & quarterly report Output % 25% 40% 50% 60% HMIS 106a Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 16
17 Objective 3: To increase case detection rate of MDR/RR/-TB from 17% in 2015/16 to 51% in 2019/20 and raise the treatment success rate from 74% in 2015/16 to 80% by 2019/ Number and percentage of detected MDR/RR-TB patients among estimated MDR/RR TB cases 3.2. Treatment success rate for MDR/RR-TB cases TB ,041 Outcome % 17% 21% 32% 42% 1,278 quarterly 51%, Lab DR-TB Outcome % 74% 75% 76% 78% 80% surveillance system Strategic intervention 3.1: Ensure early detection of MDR/RR/-TB Percentage of previously treated TB patients tested for MDR TB with documented Genexpert MTB/Rif or culture result TB Output % 65% 73% 80% 87% 95% quarterly Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 17
18 Percentage of close contacts of MDR/RR-TB patients traced and screened for TB at least once DR-TB Output % 96% 97% 98% 99% 100% unit registers Strategic intervention 3.2: Ensure early initiation of treatment and improve the quality of care for MDR/RR-TB patients Number (%) of confirmed DR-TB cases started on DR-TB treatment Output 2015 Year Value 2015/ / / / / (78%) 311 (78%) 398 (80%) 663 (85%) 937 (90%) 1214 (95%) source DR-TB surveillanc e system Strategic intervention 3.3: Expand access to and improve MDR/RR/-TB patient management (including home-based care for patients unable to visit a follow-up facility) Number of functional MDR/RR- TB treatment initiation sites DR-TB Output surveillance system Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 18
19 Strategic intervention 3.4: Implement Infection control practices in all MDR/RR/-TB treatment initiation and follow-up facilities as well as in communities. Baseline Targets Year Value 2015/ / / / /20 Data source Number of health workers diagnosed with DR- TB in the previous one year Output <5 <5 <5 <5 assessments Strategic intervention 3.5: Strengthen data management, monitoring and evaluation of MDR-TB care Percentage of MDR/RR-TB treatment facilities submitting timely, complete according to national guidelines NTLP Output 2015 Unknown Unknown >90% 100% 100% 100% DHIS2 Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 19
20 Objective 4: To strengthen systems for effective management of tuberculosis and leprosy services to meet the NSP targets Strategic intervention 4.1: Advocate for increased financial resources from domestic sources and ensure efficient and effective use of available finances Percentage of the NTLP annual budget funded by government NTLP Output % 4% 6% 9% 12% 15% central unit Percentage of TB affected households that experience catastrophic costs due to TB Output 2015 Unknown Unknown 30% [Update after survey] 25% 20% 10% NTLP central unit Strategic intervention 4.2: Engage communities and stakeholders in TB and leprosy prevention and care New community TB and leprosy groups active in TB and leprosy care USTP Output annual Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 20
21 Strategic intervention 4.3: Improve human resource capacity at all levels to effectively deliver TB and leprosy services Proportion of filled positions in the NTLP human resources structure NTLP Output % 33% 40% 45% 50% 50% annual report Strategic intervention 4.5: Improve the quality of TB care and ensure patient safety at all levels Percentage of initial loss to follow up Output % 11% 8% <5% <5% <5% DQA report, surveys Loss to follow up rate for notified cases Output % 11% 9% 5% <5% <5% TB quarterly Strategic intervention 4.6: Improve availability of quality assured TB and leprosy medicines, supplies and equipment at all levels Percentage of treatment units reporting no stock outs of anti-tb medicines in the last 3 months before assessment LMIS Output % 69% 80% 85% 90% 95% quarterly Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 21
22 Percentage of diagnostic and treatment units reporting no stock outs of TB lab supplies in the last 3 months before assessment LMIS Output 2015 Unknown >90% >90% >95% >95% >95% quarterly Strategic intervention 4.7: Strengthen M&E systems for tracking performance and measuring outcomes and impacts to guide decision-making Percentage of districts submitting timely, complete according to national guidelines (factor = timeliness x completeness) NTLP/DHI Output 2015 Unknown Unknown >90% >90% >90% >90% S2 Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 22
23 Strategic intervention 4.8: Implement NTLP-led TB research agenda in collaboration with the Uganda TB research community Operational research projects conducted and findings disseminated NTLP Output report Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 23
24 Leprosy Goal: To reduce the incidence of Grade 2 disabilities (Gr2D) among new leprosy cases from 2.3 per million population in 2014 to less than 1 per million population by 2019/ To increase the proportion of leprosy endemic districts with annual plans containing leprosy activities aligned to NSP from 50% in 2014 to over 95% in To reduce the proportion of new child leprosy cases with Grade 2 disabilities from 12% in 2014 to zero by To increase Multi Bacillary MDT completion from 91% in 2014 to 95% in To increase the proportion of persons affected by leprosy with insensitive feet who are provided protective footwear from 50% in 2014 to 100% in To increase the proportion of persons affected by leprosy accessing self-care support from less than 5% in 2014 to 35% in Baseline Targets Year Value Data source L.1 Prevalence of grade 2 disabilities among new cases/1,000,000 population Impact per million < 1 per 1 million Leprosy quarterly L.2 Percentage of new cases of Leprosy leprosy with grade Outcome % 30% 28% 23% 19% 16% 15% quarterly 2 disabilities Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 24
25 Strategic intervention L1. Increase the proportion of leprosy endemic districts with annual plans containing leprosy activities aligned to NSP from 50% in 2014 to over 95% in 2020 Baseline Targets Year Value Data source L.1.1 Percentage of leprosy districts endemic with annual plans containing leprosy Output % 60% 80% 90% >95% >95% >95% Supervisory activities aligned to NSP Strategic intervention L.2. Reduce the proportion of new child leprosy cases with Grade 2 disabilities from 12% in 2014 to zero by Baseline Targets Year Value Data source L.2.1 Percentage of new child leprosy cases with Grade 2 disabilities from Output % 12% 12% 9% 6% 3% 0% NTLP quarterly 12% in 2014 to zero by Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 25
26 Strategic intervention L.3. Increase the Multi Bacillary MDT completion from 91% in 2014 to 95% by 2019/20. Baseline Targets Year Value Data source L.3.1 Percentage of MB leprosy cases that successfully complete Outcome % 85% 87% 90% 92% 95% >95% Leprosy quarterly prescribed MDT Strategic intervention L.4. Increase the proportion of persons affected by leprosy with insensitive feet who are provided protective footwear from 50% in 2014 to 100% in Baseline Targets Year Value Data source L.4.1 Percentage of leprosy affected Leprosy persons in need of Output % 60% 70% 80% 90% 100% 100% quarterly protective footwear actually provided Strategic intervention L.5. To increase proportion of persons affected by leprosy accessing self-care support from <5% in 2014 to 35% in Baseline Targets Data source Year Value L.5.1 Percentage of persons affected by leprosy accessing self-care support Outcome % 5% 5% 10% 15% 25% 35% Leprosy quarterly Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 26
27 Table 3: definitions Definition Numerator Denominator Number of all new and relapse TB 1.0 Incidence Rate patients per 100,000 population per year determined from longitudinal survey 1.1. Notification rate of Number of notified new and relapse TB Number of notified new and incident TB cases (CNR) per patients in a calendar year per 100,000 relapse TB patients in a calendar Number of inhabitants 100,000 population population year 1.2. Treatment success rate for incident TB cases Number of notified new and relapse TB patients who are cured plus those who completed treatment as a percentage of all notified new and relapse TB patients in a given period Number of notified new and relapse TB patients who are cured plus those who completed treatment All notified new and relapse TB patients in a given period Number of New Bacteriologically 1.3. Cure rate among new PBC Confirmed (P-BC) patients declared Cured as a percentage of total Number of new P-BC cases Number of new P-BC cases with cured treatment outcome Total Number of new P-BC cases Number of notified TB patients (all 1.4. Treatment success rate among all forms of TB forms) who are cured plus those who completed treatment as a percentage of notified TB patients (all forms) in a Number of notified TB patients (all forms) who are cured plus those who completed treatment Notified TB patients (all forms) in a given period given period 1.5. Case fatality rate among all forms of TB Number of notified TB patients (all forms) who died while on TB treatment as a percentage of notified TB patients (all forms) in a given period Number of notified TB patients (all forms) who died while on TB treatment Notified TB patients (all forms) in a given period Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 27
28 Definition Numerator Denominator Number of notified TB patients (all 1.6. Loss to follow up rate among all forms of TB forms) who were lost to follow up while on TB treatment as a percentage of notified TB patients (all forms) in a Number of notified TB patients (all forms) who were lost to follow up while on TB treatment Notified TB patients (all forms) in a given period given period Percentage of children Number of notified incident (new and aged younger than 15 years relapse) TB patients younger than 15 Number of notified new & relapse Number of notified new and among all forms of incident years of age in the period under review TB patients younger than 15 years relapse TB patients in period under (new and relapse) TB cases as a percentage of the total number of age in the period under review review notified notified (new + relapse) TB patients Number of Number of bacteriologically confirmed bacteriologically confirmed patients (new and relapse) TB patients patients notified in the period under review Patients tested using a WHO Percentage of new and relapse TB Patients tested using WHO recommended rapid tests at time of diagnosis recommended rapid test at the time of diagnosis, divided by the total number of new and relapse TB Number of patients tested using a WHO recommended rapid test at the time of diagnosis Total number of new and relapse TB patients patients, expressed as a percentage Number of TB patients with DST results for at least rifampicin divided by the total number of notified (new and Drug susceptibility testing (DST) coverage (%) retreatment) cases in the same year, expressed as a percentage. DST coverage includes results from Number of TB patients (new and retreatment) with DST results for at least rifampicin Total number of notified (new and retreatment) cases in the same year molecular (e.g. Xpert MTB/RIF) as well as conventional phenotypic DST results. Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 28
29 Definition Numerator Denominator Percentage of labs participating in external quality assurance (EQA). Number of laboratories participating in EQA (defined as sending slides for blind rechecking) as a percentage of the total number of laboratories with smear microscopy Number of laboratories participating in EQA (defined as sending slides for blind rechecking) Number of laboratories with smear microscopy Number of false negative slides (slide Percentage of high false read as negative when the controller Number of false negative slides negative reported in diagnostic reads positive 1, 2 or 3) as a (slide read as negative when the Number of slides rechecked and treatment units. percentage of number of all slides controller reads positive 1, 2 or 3) rechecked Number of new and relapse cases that TB Treatment coverage (%) were notified and treated, divided by the estimated number of incident TB cases in the same year, Number of new and relapse cases notified and treated in a given year Estimated number of incident TB cases in the same year expressed as a percentage. Number of TB patients treated with Treatment coverage new TB drugs (%) regimens that include new (endorsed after 2010) TB drugs, divided by the number of notified patients eligible for treatment with new TB drugs, Number of TB patients treated with regimens that include new (endorsed after 2010) TB drugs The number of notified patients eligible for treatment with new TB drugs expressed as a percentage Percentage of TB cases (all forms) notified in DTUs who were referred by the village health team or CSO. Number of TB cases (all forms) notified in DTUs who were referred by VHT/CSO as a percentage of all TB cases (all forms) notified Number of TB cases (all forms) notified in DTUs referred by VHT/CSO Number of all TB cases (all forms) notified Contact investigation coverage Number of contacts of people with bacteriologically-confirmed TB who were evaluated for TB, divided by the Number of contacts of people with bacteriologically-confirmed TB who were evaluated for TB Total number of contacts of people with bacteriologically confirmed TB Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 29
30 Definition Numerator Denominator number eligible, expressed as a percentage. Number of PBC-TB patients whose Contact investigation coverage among PBC-TB contacts have been traced and investigated for TB as a percentage of all PBC-TB patients diagnosed in a Number of PBC-TB patients whose contacts have been traced and investigated for TB PBC-TB patients diagnosed in a given period given period Number of close contacts (<5years) of PTB patients provided IPT Number of close contacts (<5years) of PTB patients provided IPT Number of children younger than Latent TB treatment (IPT) coverage (<5years contacts of PTB patients) years who are household contacts of cases started on latent TB infection (LTBI) treatment, divided by the number eligible for treatment, expressed as a Number of children younger than 5 years who are household contacts of cases started on LTBI treatment Total number of children younger than 5 years eligible for LTBI percentage Proportion of mapped CSOs that are implementing TB control activities Number of mapped CSOs that are implementing TB control activities as a percentage of all CSO s registered with URSB Number of mapped CSOs that are implementing TB control activities Total number of CSO s registered with URSB Proportion of mapped CSO s reporting using recommended tools Number of mapped CSOs that are reporting using recommended TB tools as a percentage of mapped CSO s implementing TB control activities Number of mapped CSOs that are reporting using recommended TB tools Number of mapped CSOs that are implementing TB control activities Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 30
31 Definition Numerator Denominator Number of mapped CSOs that are Proportion of mapped CSOs trained in TB management trained in TB management as a percentage of mapped CSO s Number of mapped CSOs that are trained in TB management Number of mapped CSOs that are implementing TB control activities implementing TB control activities Percentage new prisoners screened for TB (entry screening) Number of new prisoners screened for TB (entry screening) as a percentage of number of all prisoners entering the prison system Number of new prisoners screened for TB by entry screening Number all prisoners entering the prison system Number bacteriological confirmed TB in new prisoners Number bacteriological confirmed TB in new prisoners found through entry screening Number of private forprofit and private not-forprofit health facilities accredited to function as diagnostic and treatment units Number of private for-profit and private not-for-private health facilities functioning as DTUs (DTUs) Number of bacteriologically confirmed patients (new and previously treated Number of bacteriologically Treatment success rate for incident TB cases on firstline drugs in cities and municipalities relapse) TB patients in the period under review successfully treated (cured and treatment completed) as a percentage of the total number bacteriologically confirmed patients confirmed patients (new and previously treated relapse) TB patients in the period under review successfully treated (cured and treatment completed) in cities and Number bacteriologically confirmed patients starting firstline drugs in cities and municipalities starting First Line Drugs (FLD) in cities municipalities and municipalities Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 31
32 Definition Numerator Denominator Contact investigation coverage in cities and municipalities Number of contacts of people with bacteriologically-confirmed TB in cities and municipalities who were evaluated for TB, divided by the number eligible, expressed as a percentage. Number of contacts of people with bacteriologically-confirmed TB in cities and municipalities who were evaluated for TB Total number of contacts of people with bacteriologically confirmed TB in cities and municipalities Number of close contacts (<5years) of PTB patients Number of close contacts (<5years) of provided isoniazid preventive PTB patients provided IPT in cities and therapy (IPT) in cities and municipalities municipalities Latent TB treatment (isoniazid preventive therapy) coverage (<5years contacts of PTB patients) in cities and municipalities Number of children younger than 5 years who are household contacts of cases started on LTBI treatment in cities & municipalities, divided by the number eligible for treatment, expressed as a percentage Number of children younger than 5 years who are household contacts of cases started on LTBI treatment in cities and municipalities Total number of children younger than 5 years eligible for LTBI in cities and municipalities 2.1. Percentage of TB patients co-infected with HIV who started on and/or continued anti-retroviral therapy (ART) Number of HIV-positive TB patients started on and/or continued ART as a percentage of all HIV+ TB patients notified in the period under review Number of HIV-positive TB patients on ART in the period under review Number of all HIV+ TB patients notified in the period under review Percentage of TB/HIV joint planning meetings held Number of TB/HIV joint planning meetings held as a percentage of the number of planned meetings Number of TB/HIV joint planning meetings held Number of planned meetings Percentage of TB (HCIV and above) and HIV clinics providing TB/HIV services in an integrated manner Number of TB (HCVI and above) and HIV clinics implementing one-stop centre model for co-infected TB patients as a percentage of total number of ART accredited facilities Number of TB (HCVI and above) and HIV clinics implementing onestop centre model for co-infected TB patients Total number of TB (HCVI and above) and HIV clinics Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 32
33 Definition Numerator Denominator Percentage of registered TB patients with documented HIV status Number of TB patients with known HIV status as a percentage of all notified TB patients in the period under review Number of TB patients with known HIV status Number of all notified TB patients Percentage of HIVpositive TB patients who started on and/or continued co-trimoxazole preventive treatment (CPT) Number of HIV-positive TB patients treated with CPT as a percentage of all HIV+ TB patients notified in the period under review Number of HIV-positive TB patients treated with CPT in the period under review Number of all HIV+TB patients notified in the period under review Number of people living with HIV who Percentage of people living with HIV who were newly enrolled in HIV care and screened for TB were newly enrolled in HIV care and screened for TB, divided by the total number of people living with HIV eligible for screening for TB, expressed Number of people living with HIV who were newly enrolled in HIV care and screened for TB in a given period Total number of people living with HIV who were newly enrolled in HIV care in the same period as a percentage Latent TB treatment (IPT) coverage among people living with HIV newly enrolled in HIV care Number of people living with HIV newly enrolled in HIV care started on LTBI treatment (IPT) divided by the number eligible for treatment, expressed as a percentage. Number of people living with HIV newly enrolled in HIV care started on LTBI treatment (IPT) Total number of people living with HIV newly enrolled in HIV care eligible for LTBI (IPT) Number of health Number of health workers diagnosed workers diagnosed with TB in with TB in the last year at health the last year facilities Number of prisoners screened at least Percentage of prisoners screened for TB in the last year once for TB in a given period divided by total number of prisoners in the same period, expressed as a Number of prisoners screened at least once for TB in a given period Number of prisoners screened at least once for TB in the same period percentage Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 33
34 Definition Numerator Denominator 3.1. Number and percentage of detected MDR/RR-TB patients among estimated MDR/RR TB cases Number of detected MDR/RR-TB patients as a percentage of estimated MDR/RR-TB cases Number of detected MDR/RR-TB patients Number of estimated MDR/RR-TB patients in the population Number of MDR/RR-TB patients who 3.2. Treatment success rate for MDR/RR-TB cases have cured plus those who completed treatment as a percentage of total number of MDR/RR TB patients started Number of MDR/RR-TB patients who have cured plus those who completed treatment Total number of MDR/RR TB patients started on treatment in a given period on treatment in a given period Percentage of previously treated TB patients tested for MDR TB with documented Genexpert MTB/Rif or culture result Number of previously treated TB patients tested for MDR TB with documented Genexpert MTB/Rif or culture result as a percentage of the total number of previously treated TB patients in a given period Number of previously treated TB patients tested for MDR TB with documented Genexpert MTB/Rif or culture result Total number of previously treated TB patients in a given period Percentage of close contacts of MDR/RR-TB patients traced and screened for TB at least once Percentage of close contacts of MDR/RR-TB patients traced and screened for TB at least once Number of close contacts of MDR/RR-TB patients traced and screened for TB at least once Number of close contacts of MDR/RR-TB patients Number of confirmed MDR/RR-TB cases started on MDR/RR-TB treatment Number of confirmed MDR/RR-TB cases started on MDR/RR-TB treatment Number of functional MDR/RR-TB treatment initiation sites Number of functional MDR/RR-TB treatment initiation sites Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 34
35 Definition Numerator Denominator Number of health workers diagnosed with MDR/RR-TB in the previous one year Number of health workers diagnosed with MDR/RR-TB in the previous one year Percentage of MDR/RR- Number of MDR/RR-TB treatment TB treatment facilities facilities submitting timely and Number of MDR/RR-TB treatment Total number of MDR/RR-TB submitting timely and complete as a percentage of facilities submitting timely and treatment facilities in the same complete according to total number of DR-TB treatment complete period under review national guidelines facilities in a given period Percentage of the NTLP annual budget funded by government Percentage of the NTLP annual budget funded by government contribution from the Government of Uganda NTLP budget per the National Strategic Plan Percentage of TB affected households that experience catastrophic costs due to TB Number of people treated for TB (and their households) who incur catastrophic costs (direct and indirect combined), divided by the total number of people treated for TB. Number of people treated for TB (and their households) who incur catastrophic costs (direct and indirect combined) Total number of people treated for TB New TB and leprosy Number of new TB and leprosy community groups active in TB community groups active in TB and and leprosy care leprosy care Proportion of filled positions in the NTLP human resources structure Number of filled positions in the NTLP human resources structure as a percentage of the number in the NTLP human resources structure Number of filled positions in the NTLP human resources structure Total number of positions in the NTLP human resources structure Percentage of initial loss to follow up Number of diagnosed TB patients who do not initiate treatment divided by total number of diagnosed TB patients Number of diagnosed TB patients who do not initiate treatment in a given period of time Total number of diagnosed TB patients in the same period of time Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 35
36 Definition Numerator Denominator in the same period of time, expressed as a percentage Number of diagnosed TB patients who do not initiate treatment plus those Number of diagnosed TB patients Loss to follow up rate for notified cases who initiate treatment but do not complete treatment divided by total number of diagnosed TB patients in who do not initiate treatment plus those who initiate treatment but do not complete treatment in a Total number of diagnosed TB patients in the same period of time the same period of time, expressed as given period of time a percentage Percentage of treatment units reporting no stock-outs of anti-tb medicines in the last 3 months before assessment Number of health facilities reporting no stock-outs of anti-tb medicines in the last 3 months before assessment as a percentage of the number of health facilities assessed Number of health facilities reporting no stock-outs of anti-tb medicines in the last 3 months before assessment Total number of health facilities assessed Percentage of diagnostic and treatment units (DTUs) reporting no stock-outs of TB lab supplies in the last 3 months before assessment Percentage of DTUs reporting no stock-outs of TB lab supplies in the last 3 months before assessment Number of DTUs reporting no stock outs of TB laboratory supplies in the last 3 months before assessment Total number of DTUs assessed Percentage of districts submitting timely and complete according to national guidelines Number of districts submitting timely and complete according to national guidelines (factor = timeliness x completeness) as a percentage of number of district submitting Number of districts submitting timely and complete according to national guidelines (factor = timeliness x completeness) Total number of district submitting Operational research Number of operational research projects conducted and projects conducted and findings findings disseminated disseminated Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 36
37 Definition Numerator Denominator L.1 Prevalence of grade 2 disabilities among new cases/1,000,000 population Number of leprosy patients with grade 2 disabilities among new cases/1,000,000 population Number of leprosy patients with grade 2 disabilities among new cases population L.2 Percentage of new cases of leprosy with grade 2 disabilities Number of leprosy patients with grade 2 disabilities as a percentage of new leprosy cases Number of leprosy patients with grade 2 disabilities Total number of new leprosy cases L.1.1 Percentage of leprosy endemic districts with annual plans containing leprosy activities aligned to NSP Number of leprosy endemic districts with annual plans containing leprosy activities aligned to NSP as a percentage of the number of leprosy endemic districts Number of leprosy endemic districts with annual plans containing leprosy activities aligned to NSP Total number of leprosy endemic districts L.2.1 Percentage of new child leprosy cases with Grade 2 disabilities Number of new child leprosy cases with Grade 2 disabilities as a percentage of total number of leprosy cases with grade 2 disabilities Number of new child leprosy cases with Grade 2 disabilities Total number of leprosy cases with grade 2 disabilities L.3.1 Percentage of Multi Bacillary leprosy cases that successfully complete prescribed MDT Number of Multi Bacillary leprosy cases that successfully complete leprosy MB treatment as a percentage of total number of MB leprosy cases Number of MB leprosy cases that successfully complete leprosy MB treatment Total number of MB leprosy cases L.4.1 Percentage of leprosy affected persons in need of protective footwear actually provided Number of leprosy affected persons in need of protective footwear actually provided as a percentage of the people in need of protective footwear Number of leprosy affected persons in need of protective footwear actually provided Total number of leprosy affected persons in need of protective footwear L.5.1 Percentage of persons Number of persons affected by leprosy affected by leprosy accessing self-care support accessing self-care support as a percentage of total number of leprosy affected persons Number of persons affected by leprosy accessing self-care support Total number of leprosy affected persons Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 37
38 Table 4: List of indicators to be included into DHIS2 name Denominator Description Numerator Description Multiplier factor Expected TB cases National projected Population 234 Expected MDR-TB cases (All New TB cases X 0.014) +( (Total all - total New) X 0.121) TB Case Detection Rate per 100,000 Pop National projected Population New + Relapse bacteriologically confirmed PTB (P- BC) cases TB Case notification for all TB forms (new & relapse) per 100,000 population National projected Population All New + all Relapse TB cases TB prevalence rate per 100,000 Pop National projected Population Total number of TB cases Percentage of TB patients on DOT Total number of all TB cases registered in the same period Number of patients on DOT(Facility + Community based DOT) 100 Percentage of TB patients tested for HIV Percentage of TB/HIV co-infected patients Total number of all TB cases registered in the same period Number of TB cases tested for HIV 100 Total Number of TB cases tested for HIV Number of TB cases tested HIV positive 100 Percentage of HIV-positive TB patients treated with Cotrimoxazole prophylaxis (CPT) Number of TB cases tested HIV positive Number of HIV-positive TB patients treated with Cotrimoxazole prophylaxis (CPT) 100 Uganda NTLP Rev. National Strategic Plan 2015/ /20 Monitoring & Evaluation 38
Session-1: Template for country presentation (EXISTING Indicators)
Session-1: Template for country presentation (EXISTING Indicators) Instruction This presentation is expected to provide Country perspective on use of following Existing indicators among the top 10 indicators
More informationMinistry of Health. National Tuberculosis Control Program INTEGRATED TB HIV PROGRAM REPORT (JANUARY JUNE 2015)
Ministry of Health National Tuberculosis Control Program INTEGRATED TB HIV PROGRAM REPORT (JANUARY JUNE 2015) Contents Executive summary... 2 Background... 3 National Tuberculosis Program Overview... 3
More informationMODULE SIX. Global TB Institutions and Policy Framework. Treatment Action Group TB/HIV Advocacy Toolkit
MODULE SIX Global TB Institutions and Policy Framework Treatment Action Group TB/HIV Advocacy Toolkit 1 Topics to be Covered Global TB policy and coordinating structures The Stop TB Strategy TB/HIV collaborative
More informationANALYSIS AND USE OF HEALTH FACILITY DATA. Guidance for tuberculosis programme managers
ANALYSIS AND USE OF HEALTH FACILITY DATA Guidance for tuberculosis programme managers WORKING DOCUMENT SEPTEMBER 2018 World Health Organization 2018 All rights reserved. This is a working document and
More informationAnnex A: Impact, Outcome and Coverage Indicators (including Glossary of Terms)
IMPACT INDICATORS (INDICATORS PER GOAL) HIV/AIDS TUBERCULOSIS MALARIA Reduced HIV prevalence among sexually active population Reduced HIV prevalence in specific groups (sex workers, clients of sex workers,
More informationTuberculosis prevention: An under prioritized YET critical intervention to reduce child tuberculosis morbidity and mortality
Tuberculosis prevention: An under prioritized YET critical intervention to reduce child tuberculosis morbidity and mortality Moorine Penninah Sekadde Childhood TB focal point, NTP Uganda Annual meeting
More informationWorld Health Organization HIV/TB Facts 2011
World Health Organization HIV/TB Facts 20 Note: The facts and figures of the HIV/TB Facts 20 are drawn from WHO HIV and TB surveillance data from 200 and 2009, as referenced below. Why is tuberculosis
More informationDefinitions and reporting framework for tuberculosis 2013 revision. Dennis Falzon Global Forum of Xpert MTB/RIF Implementers Annecy 17 April 2013
Definitions and reporting framework for tuberculosis 2013 revision Dennis Falzon Global Forum of Xpert MTB/RIF Implementers Annecy 17 April 2013 2-year revision process WHO/HTM/TB/2013.2 2 www.who.int/iris/bitstream/10665/79199/1/9789241505345_eng.pdf
More informationGuidance on Matching Funds: Tuberculosis Finding the Missing People with TB
February 2017 Guidance on Matching Funds: Tuberculosis Finding the Missing People with TB 1. Background TB is the leading cause of death by infectious disease, killing 1.8 million people in 2015. Each
More informationCosting of the Sierra Leone National Strategic Plan for TB
Costing of the Sierra Leone National Strategic Plan for TB 2016-2020 Introduction The Government of Sierra Leone established the National Leprosy Control Programme in 1973 with support from the German
More informationEnd TB Strategy top 10 indicators: current status in participant countries
End TB Strategy top 10 indicators: current status in participant countries Dennis FALZON Global TB Programme, WHO/HQ Geneva Regional WHO / Global Fund meeting Kenya 20 September 2016 Objectives of the
More informationImplementing revised TB/HIV recording and reporting tools Country Experience. Dr Nathan Kapata National TB/ Leprosy Programme Manager
Implementing revised TB/HIV recording and reporting tools Country Experience Dr Nathan Kapata National TB/ Leprosy Programme Manager Outline Objective Background Implementation of TB/HIV collaborative
More informationCurrent status of implementation and monitoring and evaluation of collaborative TB/HIV activities. Avinash Kanchar
Current status of implementation and monitoring and evaluation of collaborative TB/HIV activities Avinash Kanchar Outline WHO guide to M&E of collaborative TB/HIV activities: 2015 Reporting status on Global
More informationTB Control activities and Success factors and Challenges for monitoring and Evaluation of the Mangement of LTBI in Cambodia
TB Control activities and Success factors and Challenges for monitoring and Evaluation of the Mangement of LTBI in Cambodia Global Consultation on Programmatic Management of LTBI 27-28 /04/ 2016 Seoul,
More informationIPT IMPLEMENTATION- SWAZILAND EXPERIENCE
IPT IMPLEMENTATION- SWAZILAND EXPERIENCE Gugu Mchunu-National TB/HIV coordinator Programmatic Management of Latent TB infection consultation meeting Seoul, Republic of Korea,27-28 APRIL,2016 TB Epidemiology
More informationEthiopia. Targeted Tuberculosis Case Finding Interventions in Six Mining Shafts in Remote Districts of Oromia Region in Ethiopia PROJECT CONTEXT
Technical BRIEF Photo Credit: Challenge TB Targeted Tuberculosis Case Finding Interventions in Six Mining Shafts in Remote Districts of Oromia Region in Ethiopia PROJECT CONTEXT Ethiopia is the second-most
More informationImplementation and scale-up of the Xpert MTB/RIF system for rapid diagnosis of TB and MDR-TB. Global Consultation
Implementation and scale-up of the Xpert MTB/RIF system for rapid diagnosis of TB and MDR-TB Global Consultation Geneva, 30 November 2010 Mario C. Raviglione, M.D. Director, Stop TB Department WHO, Geneva,
More informationPROJECT AXSHYA COMMUNITY ENGAGEMENT in TB CARE
PROJECT AXSHYA COMMUNITY ENGAGEMENT in TB CARE An NGO-consortium initiative by World Vision India & Partners 4 th Dec 15 CSOs TB Project supported by The GFATM Round 9 grant PR: World Vision India SRs:
More informationKenya Perspectives. Post-2015 Development Agenda. Tuberculosis
Kenya Perspectives Post-2015 Development Agenda Tuberculosis SPEAKERS Anna Vassall Anna Vassall is Senior Lecturer in Health Economics at the London School of Hygiene and Tropical Medicine. She is a health
More informationTUBERCULOSIS AND HIV/AIDS: A STRATEGY FOR THE CONTROL OF A DUAL EPIDEMIC IN THE WHO AFRICAN REGION. Report of the Regional Director.
30 August 2007 REGIONAL COMMITTEE FOR AFRICA ORIGINAL: ENGLISH Fifty-seventh session Brazzaville, Republic of Congo, 27 31 August Provisional agenda item 7.8 TUBERCULOSIS AND HIV/AIDS: A STRATEGY FOR THE
More informationXpert MTB/RIF use for TB diagnosis in TB suspects with no significant risk of drug resistance or HIV infection. Results of Group Work
Xpert MTB/RIF use for TB diagnosis in TB suspects with no significant risk of drug resistance or HIV infection Results of Group Work DOTS expansion and enhancement Objective This group deals with the majority
More information7.5 South-East Asian Region: summary of planned activities, impact and costs
PART II: GLOBAL AND REGIONAL SCENARIOS FOR TB CONTROL 26 215 7.5 South-East Asian Region: summary of planned activities, impact and costs Achievements DOTS expanded rapidly in the South-East Asian Region
More informationInvesting for Impact
Global Fund Strategic Framework: Investing for Impact M&E: Capturing data to improve services Workshop to Scale Up the Implementation of Collaborative TB/HIV Activities in Africa 10-11 April, 2013; Maputo,
More informationApplication of the Onion model to assess the extent of missing tuberculosis cases by the National Programmes
Application of the Onion model to assess the extent of missing tuberculosis cases by the National Programmes Dr Amal Bassili Stop TB unit, WHO, Regional Office for the Eastern Mediterranean Surveillance
More informationTAG-ICW TB/HIV UNGASS Report 2009.
TAG-ICW TB/HIV UNGASS Report 2009. Mechanism to engage the civil society in TB/HIV M&E Francis G. Apina (NETMA+) and J. Syed (TAG) 16 th TB/HIV WG Core Group Meeting Almaty Kazakhstan 26-28 th May 2010.
More information2010 global TB trends, goals How DOTS happens at country level - an exercise New strategies to address impediments Local challenges
Outline of what it will take Tuberculosis Elimination 25: Global and Local Challenges Anne Fanning, MD November 9, 211 21 global TB trends, goals How DOTS happens at country level - an exercise New strategies
More informationThe Western Pacific Region faces significant
COMBATING COMMUNICABLE DISEASES A medical technician draws blood for HIV screening in Manila. AFP elimination of mother-to-child transmission of HIV and congenital syphilis was piloted in Malaysia and
More informationLatest developments in WHO estimates of TB disease burden
Latest developments in WHO estimates of TB disease burden WHO Global Task Force on TB Impact Measurement meeting Glion, 1-4 May 2018 Philippe Glaziou, Katherine Floyd 1 Contents Introduction 3 1. Recommendations
More informationAssessing the programmatic management of drug-resistant TB
Assessing the programmatic management of drug-resistant TB a. Review the programmatic management of drug-resistant TB patients with the TB manager. i. What is the size of MDR-TB problem locally? How many
More informationMozambique Draft 3Is workplan
Mozambique Draft 3Is workplan Background Mozambique is ranking the 16 th among the 22 high TB burden countries. Estimated TB incidence of all forms 409 per 100 000 population/yr (OMS) Absolute notifications
More informationIPT Policy Review South Africa. WHO TB/HIV Working Group meeting
IPT Policy Review South Africa WHO TB/HIV Working Group meeting Outline Background Policy Environment Policy and Guidelines TB/HIV Collaboration Policy development process BACKGROUND Population: 53 Million
More informationTB Infection Control Policy. Scaling-up the implementation of collaborative TB/HIV activities in the Region of the
TB Infection Control Policy Scaling-up the implementation of collaborative TB/HIV activities in the Region of the Infection Control is aimed at minimizing the risk of TB transmission within populations
More informationIntensified TB case finding among PLHIV and vulnerable population Identifying contacts Gunta Kirvelaite
Intensified TB case finding among PLHIV and vulnerable population Identifying contacts Gunta Kirvelaite Riga East Clinical hospital, Centre for tuberculosis and lung diseases. Head of outpatient department.
More informationTB IN EMERGENCIES. Disease Control in Humanitarian Emergencies (DCE)
TB IN EMERGENCIES Department of Epidemic and Pandemic Alert and Response (EPR) Health Security and Environment Cluster (HSE) (Acknowledgements WHO Stop TB Programme WHO/STB) 1 Why TB? >33% of the global
More informationSuccesses and remaining barriers to routine TB screening and implementation of IPT in Cambodia
Successes and remaining barriers to routine TB screening and implementation of IPT in Cambodia Mean Chhi Vun, MD, MPH NCHADS Director mchhivun@nchads.org Scaling up the implementation of the TB/HIV collaborative
More informationStrengthening and aligning diagnosis and treatment of drug-resistant TB in Russian Federation
LOGO Strengthening and aligning diagnosis and treatment of drug-resistant TB in Russian Federation Irina A.Vasilyeva Chief TB Specialist of the Russian Ministry of Health Central TB Research Institute,
More informationCatalytic Framework to End AIDS, TB and Eliminate Malaria in Africa by 2030
Catalytic Framework to End AIDS, TB and Eliminate Malaria in Africa by 2030 Introduction The Catalytic Framework to End AIDS, TB and Eliminate Malaria in Africa by 2030 provides an overarching policy framework
More informationCOMMUNITY-BASED TBHIV CASE-FINDING KENYAN EXPERIENCE
COMMUNITY-BASED TBHIV CASE-FINDING KENYAN EXPERIENCE Exposing a hidden epidemic Kenya TB/HIV TEAM Introduction Population: 40 million 15 th among the 22 high TB burden countries 2012: TB case notification
More informationDelivering Integrated HIV/TB Services in India: Challenges and Opportunities in National AIDS Control Program (NACP) IV.
Delivering Integrated HIV/TB Services in India: Challenges and Opportunities in National AIDS Control Program (NACP) IV. Introduction: Deshmukh Rajesh 1 Ashok Kumar 1 K.S.Sachdeva 2 Amar Shah 2 India is
More informationWHO Task Force Framework on assessment of TB surveillance data - Revisiting the "Onion model" Ana Bierrenbach WHO consultant Nov/Dec 2010
WHO Task Force Framework on assessment of TB surveillance data - Revisiting the "Onion model" Ana Bierrenbach WHO consultant Nov/Dec 2010 Task Force on TB Impact Measurement Mandate To produce a robust,
More informationRevised National Tuberculosis Control Programme (RNTCP) Dr.Kishore Yadav J Assistant Professor
Revised National Tuberculosis Control Programme (RNTCP) Dr.Kishore Yadav J Assistant Professor Global scenario*: Burden of TB Incidence : 9.6 million (58% SEAR and Western Pacific) Deaths : 1.5 million
More informationTB EPIDEMIOLOGY: IMPACT ON CHILDREN. Anneke C. Hesseling Desmond Tutu TB Centre Department Paediatrics and Child Health Stellenbosch University
TB EPIDEMIOLOGY: IMPACT ON CHILDREN Anneke C. Hesseling Desmond Tutu TB Centre Department Paediatrics and Child Health Stellenbosch University Robert Koch 1843-1910 Discovered M. tuberculosis 1882 TB deaths
More informationTB Control in Namibia : Progress and Technical Assistance
Send Orders of Reprints at reprints@benthamscience.net The Open Infectious Diseases Journal, 2013, 7, (Suppl 1: M2) 23-29 23 Open Access TB Control in Namibia 2002-2011: Progress and Technical Assistance
More informationFinding the missing TB cases
Finding the missing TB cases Optimizing strategies to enhance case detection in high HIV burden settings Dr Malgosia Grzemska Global TB Programme, WHO/HQ, Geneva SWITZERLAND Child and Adolescent TB Working
More informationMULTI-COUNTRY WESTERN PACIFIC PROGRAMME. Empowered lives. Resilient nations. PROGRAMME BRIEF OCTOBER 2017
MULTI-COUNTRY WESTERN PACIFIC PROGRAMME Empowered lives. Resilient nations. PROGRAMME BRIEF OCTOBER 2017 SUPPORTING NATIONAL PROGRAMMES The Multi-Country Western Pacific Programme seeks to improve coverage
More informationTB/HIV in the WHO European Region Overview, Priorities & Response
TB/HIV in the WHO European Region Overview, Priorities & Response 16 th Core Group Meeting TB/HIV Working Group Stop TB Partnership Almaty, Kazakhstan May 2010 Martin Donoghoe Andrei Dadu, Smiljka de Lussigny
More informationDr Richard Christopher,(Pediatrician) Ministry of Health and Social Welfare NTLP- TANZANIA Tanzania. Childhood TB Roadmap Paris 0ctober 29
Dr Richard Christopher,(Pediatrician) Ministry of Health and Social Welfare NTLP- TANZANIA Tanzania Childhood TB Roadmap Paris 0ctober 29 Status of childhood TB in Tanzania Child TB linkages with National
More informationTB Situation in Zambia/ TB Infection Control Program. Dr N Kapata Zambia National TB/Leprosy Control Programme Manager
/ TB Infection Control Program Dr N Kapata Zambia National TB/Leprosy Control Programme Manager Background Major public health problem Current (2014) notification rate is at 286/ 100,000 population. The
More informationBotswana Advocacy paper on Resource Mobilisation for HIV and AIDS
Republic of Botswana Botswana Advocacy paper on Resource Mobilisation for HIV and AIDS Page 1 June 2012 1.0 Background HIV and AIDS remains one of the critical human development challenges in Botswana.
More information10.4 Advocacy, Communication and Social Mobilization Working Group: summary strategic plan,
10.4 Advocacy, Communication and Social Mobilization Working Group: summary strategic plan, 2006 2015 Introduction A significant scaling-up of advocacy, communication and social mobilization for TB will
More informationPLANNING INTEGRATED HIV SERVICES AT THE HEALTH CENTRE
CHAPTER 2 PLANNING INTEGRATED HIV SERVICES AT THE HEALTH CENTRE 2.1 INTRODUCTION Achieving quality integrated HIV services at your health centre is dependant on good planning and management. This chapter
More informationXpert MTB/RIF assay validation experience --- impact and plan in China
Xpert MTB/RIF assay validation experience --- impact and plan in China Dr. Zhao Yanlin Chinese Center for Disease Control & Prevention Dr. Richard O Brien FIND April. 16, 2013 Progress Contribution for
More informationRegional Response Plan for TB-HIV
Regional Response Plan for TB-HIV 2017 2021 SEA-TB-370 Regional Response Plan for TB-HIV 2017 2021 Regional Response Plan for TB-HIV 2017 2021. World Health Organization 2017 Some rights reserved. This
More informationMultidrug-/ rifampicinresistant. (MDR/RR-TB): Update 2017
Multidrug-/ rifampicinresistant TB (MDR/RR-TB): Update 2017 The global TB situation (1) Estimated incidence, 2016 Estimated number of deaths, 2016 All forms of TB HIV-associated TB Multidrug- / rifampicin-resistant
More informationIntensified TB Case Finding using a TB screening tool integrated into an HIV clinical record: Experiences from the Eastern Cape Province
Intensified TB Case Finding using a TB screening tool integrated into an HIV clinical record: Experiences from the Eastern Cape Province Dr. Sabine Verkuijl Technical Advisor: TB/HIV Integration, ICAP-SA
More informationXpert MTB/RIF test Rollout and Implementation Plan
Xpert MTB/RIF test Rollout and Implementation Plan UNITED REPUBLIC OF TANZANIA MINISTRY OF HEALTH AND SOCIAL WELFARE NATIONAL TUBERCULOSIS AND LEPROSY PROGRAMME 6 Samora Machel Avenue P.O. Box 9083 11478
More informationChallenges in Scaling-up TB/HIV collaborative activities in a diverse HIV epidemic -India
Challenges in Scaling-up TB/HIV collaborative activities in a diverse HIV epidemic -India Dr. B. B. Rewari WHO National Consultant National Programme Officer (ART) National AIDS Control Organisation New
More information2. Treatment coverage: 3. Quality of care: 1. Access to diagnostic services:
The theme for World TB Day 2014 is Reach the missed 3 million. Every year 3 million people who fall ill with TB are missed by health systems and do not always get the TB services that they need and deserve.
More informationDepartment Of AIDS Control (DAC) Ministry of Health and Family Welfare, GOI Chandralok Building, 36 - Janpath, New Delhi
Department Of AIDS Control () Ministry of Health and Family Welfare, GOI Chandralok Building, 36 - Janpath, New Delhi - 110001 Minutes of Meeting of National TB/HIV Co-ordination Committee (NTCC) held
More informationTuberculosis Screening and IPT: Experience from India
Tuberculosis Screening and IPT: Experience from India Dr B.B.Rewari WHO National consultant Care, Support and Treatment National Programme Officer (ART) National AIDS Control Organization New Delhi-110001,
More informationLet s Talk TB. A Series on Tuberculosis, A Disease That Affects Over 2 Million Indians Every Year
A Series on Tuberculosis, A Disease That Affects Over 2 Million Indians Every Year Lancelot M. Pinto, MD, MSc Author Madhukar Pai, MD, PhD co-author and Series Editor Abstract Nearly 50% of patients with
More informationExpanding TB and TB/HIV Integrated Services in Thai Binh Province, Vietnam
TECHNICAL REPORT Expanding TB and TB/HIV Integrated Services in Thai Binh Province, Vietnam JANUARY 2009 This report was prepared by University Research Co., LLC (URC) for review by the United States Agency
More informationSAARC Regional Strategy for Control/Elimination of Tuberculosis
SAARC Regional Strategy for SAARC TUBERCULOSIS AND HIV/AIDS CENTRE NEPAL SAARC Regional Strategy for 2013-2017 SAARC Regional Strategy for III Abbreviations ACSM AIDS ARI ART CDR CSR DOT DRS GFATM HBC
More informationAbbreviations. Foreword. Background. End TB strategy. Regional strategic plan. Can we achieve the End TB Strategy. Global plan to End TB
TABLE OF CONTENTS Abbreviations Foreword Background End TB strategy Regional strategic plan Can we achieve the End TB Strategy The current pace of progress needs to be accelerated Global plan to End TB
More informationMultidrug-Resistant TB
Multidrug-Resistant TB Diagnosis Treatment Linking Diagnosis and Treatment Charles L. Daley, M.D. National Jewish Health University of Colorado Denver Disclosures Chair, Data Monitoring Committee for delamanid
More informationLatent TB Infection in the WHO European Region and recommendations on LTBI s M&E framework
Latent TB Infection in the WHO European Region and recommendations on LTBI s M&E framework 18 th Wolfheze workshops / 15 th NTP managers meeting, 31 May 02 June 2017 Dr Andrei DADU Technical officer, Joint
More informationMonitoring top 10 indicators. Philippe Glaziou September 2016
Monitoring top 10 indicators Philippe Glaziou September 2016 Global TB Report 2016 outline top-10 indicators 1. Introduction 2. The SDGs, End TB Strategy and a new era of global TB monitoring 3. TB disease
More informationCIVIL SOCIETY UNGASS TB/HIV COUNTRY REPORT KENYA JANUARY 2010
CIVIL SOCIETY UNGASS TB/HIV COUNTRY REPORT KENYA JANUARY 2010 Commissioned By: Treatment Action Group (TAG) and International Community of Women living with HIV/AIDS East Africa (ICW-EA). Conducted By:
More informationHIV Clinicians Society Conference TB/HIV Treatment Cascade
HIV Clinicians Society Conference-2012 TB/HIV Treatment Cascade Dr Judith Mwansa-Kambafwile Wits Reproductive Health & HIV Institute University of Witwatersrand TB/HIV Treatment Cascade Overview TB stats
More informationTowards universal access
Key messages Towards universal access Scaling up priority HIV/AIDS interventions in the health sector September 2009 Progress report Towards universal access provides a comprehensive global update on progress
More informationSURVEY FINDINGS April 28, 2017
SURVEY FINDINGS April 28, 2017 Brenda Mungai Centre for Health Solutions-Kenya, TB ARC Outline Background Survey Rationale Methods Key Findings Conclusions Call to Action KENYA TUBERCULOSIS PREVALENCE
More informationTB/HIV Monitoring & Advocacy Project Interview Tool
TB/HIV Monitoring & Advocacy Project Interview Tool This interview tool is based upon the Interim Policy on Collaborative TB/HIV Activities of the World Health Organization. 1 It is designed to help you
More informationTB/HIV Project in the Philippines. Yumiko Yanase
TB/HIV Project in the Philippines Yumiko Yanase 1 TB situation in the Philippines Global rank: 9th Incidence (all): 296 Prevalence (all): 458 TB mortality (all): 49 New MDR-TB: 3.2% Case types notified
More informationIPT BOTSWANA EXPERIENCE
IPT BOTSWANA EXPERIENCE Oaitse I Motsamai RN, MW, B Ed, MPH Ministry of Health Botswana 11 th November 2008 Addis Ababa, Ethiopia OUTLINE Botswana context Rationale for IPT in Botswana Pilot Current Programme
More informationOverview of the WHO policy on TB Infection Control and practical aspects and implementation tools for effective IC measures in Health facilities
Overview of the WHO policy on TB Infection Control and practical aspects and implementation tools for effective IC measures in Health facilities Dr. M. Angélica Salomão Medical Officer DOTS Expansion &
More informationBukoba Combination Prevention Evaluation: Effective Approaches to Linking People Living with HIV to Care and Treatment Services in Tanzania
Bukoba Combination Prevention Evaluation: Effective Approaches to Linking People Living with HIV to Care and Treatment Services in Tanzania COUNTRY: Tanzania Tanzania has successfully implemented the standard
More informationSituation of the HIV Epidemic in Cambodia
Scaling up Collaborative TB/HIV Activities: Challenges, Achievements and Opportunities for Eliminating TB Related-Deaths among PLHIV in Cambodia, by 2020 High Level International Consultation of the WHO
More informationPROGRESS ON IMPLEMENTATION OF THE 3Is IN SOUTH AFRICA. Yogan Pillay Deputy Director General Strategic Health Programmes South Africa
PROGRESS ON IMPLEMENTATION OF THE 3Is IN SOUTH AFRICA Yogan Pillay Deputy Director General Strategic Health Programmes South Africa South Africa Population: 49 320 500 Mil Province Population 2009 mid
More informationTuberculosis: Opportunities and Challenges for Achieving HIV Epidemic Control
Tuberculosis: Opportunities and Challenges for Achieving HIV Epidemic Control Suvanand Sahu Deputy Executive Director Stop TB Partnership Secretariat Tuberculosis TB epidemic is declining very slowly We
More informationThe Scaling-up of TB/HIV Collaborative Activities in the Asia-Pacific
Health System Strengthening and Sustaining the Response The Scaling-up of TB/HIV Collaborative Activities in the Asia-Pacific Jintana Ngamvithayapong-Yanai, Ph.D. On behalf of TB/HIV Working Group, the
More informationTB/HIV Collaborative activities in Rwanda: From Policy to implementation.
TB/HIV Collaborative activities in Rwanda: From Policy to implementation. Michel GASANA MD,MPH Head of TB and Other Respiratory Diseases Division. Rwanda / Ministry of Health RWANDA Superficie: 26,338
More informationNationwide scale-up of IPT and ART amongst TB patient in Cambodia: Successes and challenges
Nationwide scale-up of IPT and ART amongst TB patient in Cambodia: Successes and challenges The 17 th Core Group meeting of the TB/HIV Working group Beijing, 9-11 November 2011 Mean Chhi Vun, MD, MPH and
More informationUSAID TB CARE II Bangladesh:
B ANGLADESH USAID TB CARE II Bangladesh: Grants Spotlight This document has been developed by the TB CARE II project and is made possible by the generous support of the American people through the United
More informationUN HIGH-LEVEL MEETING ON TB KEY TARGETS & COMMITMENTS FOR 2022
UN HIGH-LEVEL MEETING ON TB KEY TARGETS & COMMITMENTS FOR 2022 UNHLM ON TB KEY TARGETS FOR 2022 WE, HEADS OF STATE AND GOVERNMENT AND REPRESENTATIVES OF STATES AND GOVERNMENTS ASSEMBLED AT THE UNITED NATIONS
More informationRam Sharan Gopali (MPH) Executive Director
Ram Sharan Gopali (MPH) Executive Director Basic Facts of Nepal Nepal is a landlocked country located in the WHO Asian region at the edge of the Himalaya between India and the Peoples Republic of China
More informationMay 26-28, 2010, Almaty, Kazakhstan November 2011
Progress note of the recommendations of the 16 th TB/HIV Core Group Meeting Report May 26-28, 2010, Almaty, Kazakhstan November 2011 1. Structural and organizational barriers The Core Group urges Ministries
More informationWorld Health Organization. A Sustainable Health Sector
World Health Organization A Sustainable Health Sector Response to HIV Global Health Sector Strategy for HIV/AIDS 2011-2015 (DRAFT OUTLINE FOR CONSULTATION) Version 2.1 15 July 2010 15 July 2010 1 GLOBAL
More informationThe United Nations flag outside the Secretariat building of the United Nations, New York City, United States of America
The United Nations flag outside the Secretariat building of the United Nations, New York City, United States of America Mike Segar / Reuters Executive Summary Context On 26 September 2018, the United Nations
More informationRevised National Tuberculosis Control Programme
Revised National Tuberculosis Control Programme 1 OUTLINE OF PRESENTATION Introduction Burden Of The Disease Evolution Of RNTCP Goals And Objectives Of RNTCP DOTS Stop TB Strategy Organization RNTCP Endorsed
More informationAnnex 13. Indicators for HIV testing services reference sheet
Annex 13. Indicators for HIV testing services reference sheet Table 13.1A Programme indicators for HIV testing services WHO/HIV/2015.32 Indicator National indicators Numerator (N)/ denominator (D) Disaggregation
More informationScaling up collaborative TB/HIV activities: achievements, challenges, and opportunities in Viet Nam
Scaling up collaborative TB/HIV activities: achievements, challenges, and opportunities in Viet Nam 20 th International AIDS Conference, 20 July 2014, Melbourne, Australia Nguyen Hoang Long, MD, Ph.D.
More informationTOG The Way Forward
TOG 2016- The Way Forward Main Changes in Diagnostic algorithm Definition (Type, Classification, Outcome) Registration at the time of Diagnosis (PHI level Notification Register) Long term follow up (till
More informationGLOBAL AIDS MONITORING REPORT
KINGDOM OF SAUDI ARABIA MINISTRY OF HEALTH GLOBAL AIDS MONITORING REPORT COUNTRY PROGRESS REPORT 2017 KINGDOM OF SAUDI ARABIA Submission date: March 29, 2018 1 Overview The Global AIDS Monitoring 2017
More informationCIVIL SOCIETY TB/HIV UNGASS MONITORING COUNTRY REPORT. Even People Living With HIV/AIDS forget about TB and concentrate on demanding HIV services only
CIVIL SOCIETY TB/HIV UNGASS MONITORING COUNTRY REPORT UGANDA JANUARY 2010 Even People Living With HIV/AIDS forget about TB and concentrate on demanding HIV services only Commissioned by: Conducted by:
More informationMonitoring and Evaluation
Monitoring and Evaluation Toolkit HIV, Tuberculosis and Malaria and Health Systems Strengthening Part 2: Tools for monitoring programs for HIV, tuberculosis, malaria and health systems strengthening HIV
More informationGlobal Fund Project for South Sudan
Global Fund Project for South Sudan 2015 Annual Report April 2016 Fluorescence Microscopy (LED illumination) in Wau Teaching Hospital s TB unit Project Summary Country: South Sudan Project Duration: 1.
More informationTHE UNITED REPUBLIC OF TANZANIA MINISTRY OF HEALTH AND SOCIAL WELFARE NATIONAL POLICY GUIDELINES FOR COLLABORATIVE TB/HIV ACTIVITIES
THE UNITED REPUBLIC OF TANZANIA MINISTRY OF HEALTH AND SOCIAL WELFARE NATIONAL POLICY GUIDELINES FOR COLLABORATIVE TB/HIV ACTIVITIES 2016 Table of Contents ABBREVIATIONS... 3 FOREWORD... 5 AKNOWLEDGEMENTS...
More informationHeather Alexander, PhD
Xpert MTB/RIF: An Opportunity to Strengthen Laboratory Systems and Bridge the Laboratory-Program Gap Heather Alexander, PhD International Laboratory Branch Division of Global HIV/AIDS Centers for Disease
More informationThe New WHO guidelines on intensified TB case finding and Isoniazid preventive therapy and operational considerations
Workshop to accelerate the implementation of the Three Is for HIV/TB and earlier initiation of ART in Southern Africa, March 14-18, 2011, Johannesburg, South Africa. The New WHO guidelines on intensified
More informationWHERE DO WE GO FROM HERE?
WHERE DO WE GO FROM HERE? WHAT WILL BE REQUIRED TO ACHIEVE ZERO DEATHS FROM TUBERCULOSIS? SALMAAN KESHAVJEE, MD, PHD, SCM HARVARD MEDICAL SCHOOL BRIGHAM AND WOMEN S HOSPITAL PARTNERS IN HEALTH INTERNATIONAL
More information