World Health Organization Regional Office for the Western Pacific Strengthening TB surveillance: regional perspective Tom Hiatt Stop TB and Leprosy Elimination World Health Organization Regional Office for the Western Pacific Ninth TAG and NTP Managers Meeting in WPR Manila, Philippines 9–12 December 2014

World Health Organization Regional Office for the Western Pacific Implementation of revised case definitions CambodiaComplete ChinaUnder discussion and planning Lao PDRTraining underway, in revised guidelines MalaysiaComplete MongoliaIn revised guidelines Papua New Guinea Planned PhilippinesComplete for PMDT, other facilities in Jan 2015 Viet NamIn upcoming revised guidelines, planned for 2015

World Health Organization Regional Office for the Western Pacific Mechanism for data analysis by subnational level staff CambodiaLimited analysis from subnational staff China Analysis primarily at the national level with feedback to subnational Lao PDRIrregular meetings at central and provincial levels MalaysiaAnalyses presented at regular meetings MongoliaYearly meetings in the rural TB units, Quarterly in UB Papua New Guinea Analyses presented at quarterly reviews at the regional level PhilippinesReview at regional and provincial/city level Viet Nam Region and provinces conduct analyses at 3, 6, 12 month intervals

World Health Organization Regional Office for the Western Pacific Recording and reporting systems Recording and reporting system Status of patient-based electronic system CambodiaeTB manager for PMDT only Full roll-out, 100% entry of enrolled patients China Electronic for DS-TB and PMDT (TBIMS) Full roll-out, 100% entry of enrolled patients Lao PDRPaper-based Electronic for PMDT under development Malaysia Electronic DS-TB and PMDT (MyTB) Full roll-out, 100% entry of enrolled patients

World Health Organization Regional Office for the Western Pacific Recording and reporting systems Recording and reporting system Status of patient-based electronic system Mongolia Paper-based and electronic (TUBIS) Full roll-out, entry complete for PMDT patients only Papua New GuineaPaper-based Philippines Paper-based and electronic (ITIS) Full roll-out for PMDT sites with ~80% entry, pilot roll- out to DS-TB sites with very low entry Viet Nam Paper and electronic for PMDT (eTB manager) and DS-TB (VITIMES) Partial roll-out for PMDT and DS-TB sites with complete entry of enrolled PMDT patients only (~65% for DS-TB)

World Health Organization Regional Office for the Western Pacific Recording and reporting – electronic systems challenges Low levels of data entry Internet connection Hardware requirements Increase in reporting load for patient- based systems Double recording (reporting) Systems are strong on M&E, but weak on health worker utility