People living with HIV who started tuberculosis preventive treatment

Export Indicator

Number of people who initiated tuberculosis preventive treatment (TPT), expressed as a percentage of the total number of people on antiretroviral therapy who are eligible for TPT during the reporting period
What it measures

The extent to which people who are on antiretroviral therapy and eligible to take TPT do initiate TPT.

Rationale

TPT reduces the risk of developing active TB and improves survival of all people living with HIV. People living with HIV should be screened for TB at every visit, using a clinical algorithm recommended by the World Health Organization (WHO). Adults and adolescents living with HIV who do not report any of the symptoms of TB - current cough, fever, weight loss or night sweats - are unlikely to have active TB and should be offered TPT. Similarly, children living with HIV who do not have poor weight gain, fever or current cough should be offered TPT regardless of whether or not they are receiving antiretroviral therapy.

Numerator

Total number of people who are on antiretroviral therapy and eligible for TPT who start TPT during the reporting period.

Denominator

Total number of people on antiretroviral therapy who are eligible for TPT during the reporting period.

Calculation

Numerator/denominator

Method of measurement

TPT should be started for all eligible people living with HIV and the start date should be recorded on the HIV care/antiretroviral therapy card (Encounter section). Those who accept treatment and receive at least the first dose should then be recorded in the antiretroviral therapy registers (TPT start month and year column).

Numerator. Count the total number of people on antiretroviral therapy during the reporting period who are eligible for TPT and who start TPT (i.e., those who receive at least one dose of the regimen).

Denominator. The formula for determining the number of people on antiretroviral therapy who are eligible for TPT during the reporting period is as follows:

Number of people living with HIV on antiretroviral therapy at the end of the last reporting period [minus] number of notified HIV-positive TB patients in last reporting period [also minis, where possible] number of people living with HIV who previously received TPT (actual, if available, or based on country estimate) [also minus, where possible] number/estimate of people living with HIV not eligible for TPT due to co-morbidities, including active hepatitis, chronic alcoholism and/or neuropathy.

For accurate planning and drug management, more detailed information needs to be collected in addition to the above. A pharmacy-based register may be used to record client attendance and drug collection. Alternatively, the HIV treatment facility may maintain a TPT register in parallel with the antiretroviral therapy register. Such a record may provide valuable information on the number of new and continuing patients on TPT, as well as treatment completion rates and adverse events.

If data are not available for people eligible for tuberculosis preventive treatment, it will be possible to report on tuberculosis preventive treatment initiation among all people living with HIV on ART.

Measurement frequency

Data should be recorded daily and reported quarterly to the national or subnational level. They should be consolidated annually and reported to UNAIDS.

Disaggregation
  • Antiretroviral initiation (new on antiretroviral therapy in the last 12 months or on antiretroviral therapy >12 months)
  • Gender (male, female or transgender)
  • Age (<5 years, 5-14 years, 15+ years)
  • Cities (see additional information requested below)

If possible:

  • Type of TPT regimen (6H, 3HP, 1HP, and Other) ["HP" refers to isoniazid and rifapentine]
Additional information requested

Please provide city-specific data for this indicator. Space has been created in the data entry sheet to provide information for the capital city as well as one or two other key cities of high epidemiological relevance (e.g., those that have the highest HIV burden or those that have committed to ending AIDS by 2030).

Strengths and weaknesses

This indicator measures the coverage of TPT among people on HIV treatment. However, it lacks the benchmark for acceptable performance. Scaling up this intervention will assist in developing such a benchmark at the national level. Unless further data are collected, this indicator provides no information on the number of individuals who adhere to or complete the course of treatment.

Further information

Driving impact through programme monitoring and management. Consolidated HIV strategic information guideliines. Geneva: World Health Organization; 2020 (https://apps.who.int/iris/bitstream/handle/10665/331697/9789240000735-en...).