People living with HIV who started tuberculosis preventive treatment

Export Indicator

Percentage of people on antiretroviral therapy who started tuberculosis (TB) preventive treatment during the reporting period
What it measures

The extent to which people who are on antiretroviral therapy started TB preventive treatment

Rationale

TB preventive treatment reduces the risk of developing active TB and improves among all people living with HIV. People living with HIV should be screened for TB at every clinic 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 TB preventive treatment. WHO recommends a number of screening tools that can be used to rule out active TB (e.g., chest x-ray, c-reactive protein).

Children living with HIV who do not have poor weight gain, fever or current cough should be offered TB preventive treatment regardless of whether or not they are receiving antiretroviral therapy.

Numerator
  1. Total number of people newly enrolled on antiretroviral therapy during the reporting period who also started TB preventive treatment during the reporting period.
  2. Total number of people currently on antiretroviral therapy who started TB preventive treatment during the reporting period.
Denominator
  1. Total number of people newly enrolled on antiretroviral therapy during the reporting period.
  2. Total number of people currently on antiretroviral therapy during the reporting period.
Calculation

Numerator/denominator

Method of measurement

TB preventive treatment 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 (under the TB preventive treatment start month and year column).

  1. Numerator. Count the total number of people living with HIV newly enrolled on antiretroviral therapy during the reporting period who also started TB preventive treatment during the same reporting period (i.e., those who receive at least one dose of the regimen).

Denominator. Count the total number of people living with HIV newly enrolled on antiretroviral therapy during the reporting period.

  1. Numerator. Count the total number of people currently on antiretroviral therapy during the reporting period who also started TB preventive treatment during the same reporting period (i.e., those who received at least one dose of the regimen).

Denominator. Count the total number of people living with HIV currently on antiretroviral therapy during the reporting period.

Countries are asked to report on 1 and/or 2, as available.

If available, also provide the number of people living with HIV currently on antiretroviral therapy who have ever received TB preventive treatment (excluding those who received it during the current reporting period).

Measurement frequency

Data on people who started antiretroviral therapy and TB preventive treatment should be recorded daily and reported quarterly to the national or subnational level. They should be consolidated annually and reported to UNAIDS.

Disaggregation
  • Age (<5 years, 5-15 years, 15+ years)
  • Cities and other administrative areas of epidemiologic importance.
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, and for one or two other key administrative areas of high epidemiological relevance, such as those that have the highest HIV burden, or cities that have committed to ending AIDS by 2030.

Strengths and weaknesses

This indicator measures the coverage of TB preventive treatment among people on HIV treatment, but 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.

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

Further information
  1. WHO guidelines on tuberculosis infection prevention and control. 2019 update. Geneva: World Health Organization; 2019 (https://apps.who.int/iris/bitstream/handle/10665/311259/9789241550512-eng.pdf).
  2. WHO consolidated guidelines on tuberculosis. Module 1: prevention. Tuberculosis preventive treatment. Geneva: World Health Organization; 2020 (https://www.who.int/publications/i/item/who-consolidated-guidelines-on-tuberculosis-module-1-prevention-tuberculosis-preventive-treatment).