EXERCISE 11: Computing and Analyzing Program Indicators You will be given the following 2012 annual reports for Province X in Region 5. (note: consolidation of quarterly reports) Report 1. Quarterly Report on TB Microscopy and GX Laboratory Examinations Report 2. Quarterly Report on EQA for TB Microscopy Report 3a. Quarterly Report on Case Finding of Drug- susceptible TB Cases and IPT Report 5a. Quarterly Report on Treatment Outcome of Drug- susceptible TB Cases

From the reports above, compute for the following indicators: Case Notification Rate (all forms) TB Case Detection Rate (all forms) – use 260/100k as incidence rate for exercise Treatment Success Rate (all forms) Cure Rate (new bacteriologically confirmed) Total number of presumptive TB examined Percent contribution from non-NTP care providers Number of children with TB detected and given treatment and those given IPT Percentage of TB cases in category A and B areas with HIV counseling and testing among aged 15 years old and above Percent of TMLs within EQA standards

CORRECTIONS on the DATA given: Report 5a. Quarterly Report on Treatment Outcome of Drug-susceptible TB Cases A. Bacteriologically Confirmed New and Relapse TB Cases Total number of TB cases Cured Comple ted Died Failed Lost to follow-up Not Evalua ted TOTAL 1,126 New 846 176 8 12 72 9 1,123 38 Relapse 25 3 1 5 34 B . Clinically Diagnosed New and Relapse TB Cases Total number of TB cases Comple ted Died Failed Lost to follow-up Not Evalua ted TOTAL 1,624 New 1,522 3 84 14 1,623 35 Relapse 30 33 D. Source of All New and Relapse Cases Total number of notified TB Cases, all forms Public Walk-in patients Other Public Facilities Private Sector Community 2,688 2,123 81 323 161

general notes in analysis   numerator denominator computed remarks general notes in analysis 1.  Case Notification Rate (all forms) No. TB, all forms population divided by 100,000 From Report 3a., table A and B, get the total number of all forms (new and relapse) “all forms” include new, relapse, and extrapulmonary TB cases (whether bacteriologically confirmed or clinically diagnosed)

Report 3a. Quarterly Report on Case Finding of Drug- Susceptible TB Cases and IPT Point out where to get the “all forms” (numerator) to compute the indicator

general notes in analysis   numerator denominator computed remarks general notes in analysis 1.  Case Notification Rate (all forms) No. TB, all forms =2,688 population divided by 100,000 1,234,345 100,000 218

Previously Treated (except Relapse) TOTAL Report 3a. Quarterly Report on Case Finding of Drug-susceptible TB Cases and IPT (Data Source: Form 6a. Drug-susceptible TB Register and Form 9. IPT Register) A. Bacteriologically confirmed TB Cases registered during the quarter by registration group and sex CLASSIFICATION NEW RELAPSE Previously Treated (except Relapse) TOTAL M F Pulmonary 678 392 10 7 19 16 707 415 Extrapulmonary 14 2 1 5 4 20 8 Subtotal 692 394 11 9 24 727 423 1,086 44 1,150 B. Clinically diagnosed TB Cases registered during the quarter by registration group and sex CLASSIFICATION NEW RELAPSE Previously Treated (except Relapse) TOTAL M F Pulmonary 789 716 16 17 52 36 857 769 Extrapulmonary 28 15 1 7 6 21 Subtotal 817 731 59 42 893 790 1,548 34 101 1,683

general notes in analysis   numerator denominator computed remarks general notes in analysis 1.  Case Notification Rate (all forms) 1,086 + 20 +1,548 +34 = 2,688 1,234,345 100,000 = 12.34 2,688 12.34 = 218

general notes in analysis   numerator denominator computed remarks general notes in analysis 2.  TB Case Detection Rate (all forms) Number of all forms of TB detected Total number of all forms estimated to occur each year (i.e., population x incidence rate of TB, all forms)  From Report 3a., table A and B, get the total number of all forms (new and relapse) used incidence rate of 260/100k for this exercise

Report 3a. Quarterly Report on Case Finding of Drug- Susceptible TB Cases and IPT Point out where to get the “all forms” (numerator) to compute the indicator

general notes in analysis   numerator denominator Computed remarks general notes in analysis 2.  TB Case Detection Rate (all forms) Number of all forms of TB detected =2,688 Total number of all forms estimated to occur each year (i.e., population x incidence rate of TB, all forms)  =3,209 84%

Previously Treated (except Relapse) TOTAL Report 3a. Quarterly Report on Case Finding of Drug-susceptible TB Cases and IPT (Data source: Form 6a. Drug-susceptible TB Register and Form 9. IPT Register) A. Bacteriologically confirmed TB Cases registered during the quarter by registration group and sex CLASSIFICATION NEW RELAPSE Previously Treated (except Relapse) TOTAL M F Pulmonary 678 392 10 7 19 16 707 415 Extrapulmonary 14 2 1 5 4 20 8 Subtotal 692 394 11 9 24 727 423 1,086 44 1,150 B. Clinically diagnosed TB Cases registered during the quarter by registration group and sex CLASSIFICATION NEW RELAPSE Previously Treated (except Relapse) TOTAL M F Pulmonary 789 716 16 17 52 36 857 769 Extrapulmonary 28 15 1 7 6 21 Subtotal 817 731 59 42 893 790 1,548 34 101 1,683

general notes in analysis   numerator denominator computed remarks general notes in analysis 2.  TB Case Detection Rate (all forms) 1,086 + 20 + 1,548 + 34 = 2,688 1,234,345 X .0026 = 3,209 2,688 3,209 = 84% Used incidence rate of 260/100k  .0026

general notes in analysis   numerator denominator computed remarks general notes in analysis 3. Treatment Success Rate (all forms) Number of All forms of TB cases cured and completed treatment Total number of all forms of TB cases registered during a specified period From Report 5a, add all cured and completed for new and relapse cases in Section A and B. Denominator will be total new and relapse evaluated.

Report 5a. Quarterly Report on Treatment Outcome of Drug-susceptible TB Cases Numerator will be the blue circle—”all forms” (new and Relapse) that were cured and treatment completed for both BC and CD. Denominator will be red circle or TOTAL. Note: If the total does not match with cases registered the previous year (1st column), this may be due to the number on the footnote or “excluded from cohort because found to be DRTB regimen”. “Missing cases” (that is=total number of new and relapse registered last year minus total evaluated minus excluded) should be added to the denominator as “not evaluated” so that the discrepancy will be accounted for.

general notes in analysis   numerator denominator computed remarks general notes in analysis 3. Treatment Success Rate (all forms) Number of all forms of TB cases cured and completed treatment =2,602 Total number of all forms of TB cases registered during a specified period =2,813 92%

A. Bacteriologically Confirmed New and Relapse TB Cases Report 5a. Quarterly Report on Treatment Outcome of Drug-susceptible TB Cases A. Bacteriologically Confirmed New and Relapse TB Cases Total number of TB cases Cured Comple ted Died Failed Lost to follow Not Evalua ted TOTAL 1,126 New 846 176 8 12 72 9 1,123 38 Relapse 25 3 1 5 34 Note: Exclude from the cohort the cases found to be drug resistant at anytime during treatment. Number of cases excluded from the cohort= __7_______ B . Clinically Diagnosed New and Relapse TB Cases Total number of TB cases Comple ted Died Failed Lost to follow Not Evalua ted TOTAL 1,624 New 1,522 3 84 14 1,623 35 Relapse 30 33 Note: Exclude from the cohort cases found to be drug resistant at anytime during treatment. Number of cases excluded from the cohort= ___3________

general notes in analysis   numerator denominator computed remarks general notes in analysis 3. Treatment Success Rate (all forms) 846 +176 + 25 + 3 +1522 +30 = 2,602 1123 + 34 + 1623 + 33 =2,813 2,602 2,813 X 100 = 92%

general notes in analysis   numerator denominator computed remarks general notes in analysis 4. Cure Rate (New Bacteriologically-confirmed) No. of new bacteriologically-confirmed TB cases cured Total number of new bacteriologically-confirmed TB cases registered during a specified period From Report 5a, get cured for new bacteriologically confirmed cases, Section A. Denominator will be total new and relapse evaluated.

Report 5a. Quarterly Report on Treatment Outcome of Drug-susceptible TB Cases

general notes in analysis   numerator denominator computed remarks general notes in analysis 4. Cure Rate (new bacteriologicallyconfirmed) No. of new bacterio-logically-confirmed TB cases cured =846 Total number of new bacterio-logically-confirmed TB cases registered during a specified period =1,123 =75%

Total number of TB cases Report 5a. Quarterly Report on Treatment Outcome of Drug-susceptible TB Cases A. Bacteriologically Confirmed New and Relapse TB Cases Total number of TB cases Cured Comple ted Died Failed Lost to follow Not Evalua ted TOTAL 1,126 New 846 176 8 12 72 9 1,123 38 Relapse 25 3 1 5 34 Note: Exclude from the cohort cases found to be drug resistant at anytime during treatment. Number of cases excluded from the cohort = __7_

general notes in analysis   numerator denominator computed remarks general notes in analysis 4. Cure Rate (new bacteriologically confirmed) =846 =1,123 846 1,123 X 100 =75%

general notes in analysis   numerator denominator computed remarks general notes in analysis 5. Total number of presumptive TB examined number of presumptive TB examined during the reporting period From Report 1a, get the total number examined by DSSM (#1).

Report 1. Quarterly Report on TB Microscopy and GX Laboratory Examinations Presumptive examined will refer to those that underwent DSSM. It does not include presumptive TB children who did not undergo DSSM and does not include Xpert. Note: reason for this is that under PhilPACT, this indicator was intended as a measure of access to microscopy services.

general notes in analysis   numerator denominator computed remarks general notes in analysis 5. Total number of presumptive TB examined number of presumptive TB examined during the reporting period =8,234 =8234

Laboratory Activities Other Retreatment Cases Report 1a.Quarterly Report on TB Microscopy and GX Laboratory Examinations Case Finding: Laboratory Activities DSSM Xpert New Relapse Other Retreatment Cases No. Examined 8,234 25 70 2. No. with positive examination result: 1,234 4 12 3. Positivity Rate* 15% 4. No. of presumptive TB case with rifampicin resistance 3 8

general notes in analysis   numerator denominator computed remarks general notes in analysis 5. Total number of presumptive TB examined 8,234

general notes in analysis   numerator denominator computed remarks general notes in analysis 6.  Percent contribution from non-NTP care providers No. of notified TB cases, all forms, referred/ managed by all non-NTP care providers (other government, private, community, etc.) Total number of notified TB cases, all forms From Report 3a., table D, add the total number from other public facilities, private and community. Denominator will be total notified TB cases, all forms.

Report 3a. Quarterly Report on Case Finding of Drug- susceptible TB Cases and IPT Non-NTP Providers

general notes in analysis   numerator denominator computed remarks general notes in analysis 6.  Percent contribution from non-NTP care providers No. of notified TB cases, all forms, referred/ managed by all non-NTP care providers (other government, private, community, etc.) =565 Total number of notified TB cases, all forms =2,688 = 21%

Report 3a. Quarterly Report on Case Finding of Drug-susceptible TB Cases and IPT C. All New and Relapse TB Cases by Age and Sex 0 to 4 5 to 14 15 to 24 25 to 34 35 to 44 45 to 54 55 to 64 >=65 TOTAL M F New 32 20 319 281 250 164 313 200 289 150 104 90 106 89 77 1,532 1,102 Relapse 7 5 16 11 2 4 1 34 Subtotal 257 169 329 211 294 152 154 105 92 107 1,566 1,122 52 600 426 540 446 259 199 166 2688 D. Source of All New and Relapse Cases Total number of notified TB Cases, all forms Public Walk-in patients Other Public Facilities Private Sector Community 2,688 2,123 81 323 161

general notes in analysis   numerator denominator computed remarks general notes in analysis 6.  Percent contribution from non-NTP care providers 81 + 323 + 161 = 565 = 2,688 565 2,688 X 100 = 21%

general notes in analysis   numerator denominator computed remarks general notes in analysis 7.  Number of children with TB detected and given treatment and those given IPT Absolute number of children with TB detected and given treatment plus those given IPT From Report 3a, add children treated in Table E and given IPT in Table G

TB in children (add to IPT below) Report 3a. Quarterly Report on Case Finding of Drug- susceptible TB Cases and IPT TB in children (add to IPT below) IPT among children

general notes in analysis   numerator denominator computed remarks general notes in analysis 7.  Number of children with TB detected and given treatment and those given IPT Absolute number of children with TB detected and given treatment plus those given IPT = 772 =772

Total TB cases less than 15 years old Report 3a. Quarterly Report on Case Finding of Drug-susceptible TB Cases and IPT E. TB in Children Total TB cases less than 15 years old Number Pulmonary 631 Extrapulmonary 21 F. HIV Status among aged 15 years and above G. Individuals Given IPT Number given IPT Children age 0-4 (without HIV) 120 PLHIV

general notes in analysis   numerator denominator computed remarks general notes in analysis 7.  Number of children with TB detected and given treatment and those given IPT 631 + 21 + 120 = 772 =772

general notes in analysis   numerator denominator computed remarks general notes in analysis 8.  Percentage of TB cases in Category A and B areas with HIV counseling and testing among aged 15 years old and above Number of registered TB cases in Category A and B areas provided with HIV counseling and testing among 15 years old and above Total number of registered TB cases in Category A and B areas 15 years old and above From Report 3a, Table F, get the number tested or known HIV status and divide by total number registered for quarter that are 15 y/o above.

Tested for HIV among those eligible Report 3a. Quarterly Report on Case Finding of Drug- Susceptible TB Cases and IPT Tested for HIV among those eligible

general notes in analysis   numerator denominator computed remarks general notes in analysis 8.  Percentage of TB cases in Category A and B areas with HIV counseling and testing among aged 15 years old and above Number of registered TB cases in Category A and B areas provided with HIV counseling and testing among 15 years old and above =1,906 Total number of registered TB cases in Category A and B areas 15 years old and above =2,171 = 88%

Report 3a. Quarterly Report on Case Finding of Drug-susceptible TB Cases and IPT F. HIV Status among aged 15 years and above Classification of Cases Number of Cases registered for the quarter No. of cases tested or with known HIV status during the quarter No. of TB cases confirmed positive for HIV Among HIV positive, number given   ART CPT Pulmonary 2,159 1,894 Extrapulmonary 12

general notes in analysis   numerator denominator computed remarks general notes in analysis 8.  Percentage of TB cases in Category A and B areas with HIV counseling and testing among aged 15 years old and above 1,894 + 12 =1,906 2,159 =2,171 1,906 2,171 X 100 =88%

general notes in analysis   numerator denominator computed remarks general notes in analysis 9. Percent of TMLs within EQA standards Number of TMLs who have less than 5% major errors (adequate performance) All TMLs providing TB laboratory services within the NTP laboratory network From Report 2a, get the total number of TMLs within EQA standard and divide by total number of TMLs.

Report 2. Quarterly Report on EQA for TB Microscopy Adequate performance = those with less than 5% ME over TOTAL TMLs

general notes in analysis   numerator denominator computed remarks general notes in analysis 9. Percent of TMLs within EQA standards Number of TMLs who have less than 5% major errors (adequate performance) =11 All TMLs providing TB laboratory services within the NTP laboratory network =15 =73%

TB Microscopy Laboratory EQA: On-site Evaluation Report 2. Quarterly Report on External Quality Assessment for TB Microscopy (Data Source: Quality Assurance Center Records) TB Microscopy Laboratory Public Private TOTAL No. of TB microscopy laboratories (TML) (A) 10 5 15 TML participating in EQA (B) (B/A) x 100 1 11 100% 20% 73% TML with <5% major errors (C) (C/A) x 100 EQA: On-site Evaluation Number TMLs with major error/s (D) 3 Feedback done by the QAC Team to discuss corrective actions (E) 2 Percentage, E/D (%) 67%

general notes in analysis   numerator denominator computed remarks general notes in analysis 9. Percent of TMLs within EQA standards =11 =15 11 15 X 100 =73%