Number of TB cases per quarter (bacteriologically confirmed cases, retreatment cases, all cases); case notification rate (cases detected during a defined period in a defined geographic area / total population of that area x 100,000) – review any unusual or inconsistent events and suggest remedial measures.
19.5 Verification of TB records
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a) For new bacteriologically confirmed cases: Total number of new bacteriologically confirmed cases becoming smear-negative after two months of treatment/total new bacteriologically confirmed cases registered during the same quarter x 100
b) for Previously Treated bacteriologically confirmed cases: total number of Previously Treated bacteriologically confirmed cases becoming smear-negative after two months of treatment/total Previously Treated bacteriologically confirmed cases registered during the same quarter x 100
These rates are expected to be around 85-90%. Investigate further in cases of low or very high conversion rates and provide feedback.
Total number of new bacteriologically confirmed cases who were declared "cured" or "Treatment Completed"/total number of new bacteriologically confirmed cases registered in the same period x 100. This rate can be calculated in the same way for Xpert MTB/RIF positive cases, Previously Treated cases, clinically diagnosed cases and extra-pulmonary cases. Review unusually high or low treatment success rates and provide feedback. The treatment completion rate (where patient has completed the full course of treatment but cannot be declared as Cured as 2 negative follow up results - including the last follow up - are not available) for bacteriologically confirmed cases should not exceed 5%.
Unsuccessful outcomes: Lost to follow up rate, failure rate, death rate and transferred-out rate. Total number of new- bacteriologically confirmed cases who were "lost to follow up", "failed", “died” or were "transferred out" / total number of new bacteriologically confirmed cases registered during the same period x 100. These rates can be calculated in the same way for Previously Treated, clinically diagnosed and extra-pulmonary cases. Analyse reasons for poor treatment outcomes and provide feedback.
Health education and counselling
- Check availability and use of updated BCC materials
- Review counselling procedures
- Interview some patients randomly
- Relate your findings with the information available on the patient cards,
- Check knowledge about the diseases, duration of treatment and consequences of interruption of treatment
Feedback is one of the most important parts of the supervision. It is encouraged to fill the checklist on the spot together with the related health personnel. This will facilitate capacity as well as relationship. Supervision report helps identify and improve areas of concern in the facility visited and also enables the subsequent supervisor visiting that facility to follow up on the recommendations made. Supervision reports should be submitted to relevant authorities and feedback must be provided to the concerned field staff and officials.