The recording and reporting system can be managed by hand. However, an electronic system is highly desirable since it facilitates better quality of information as well as data analysis; it will also obviate the need for transcription and repeated entry into different forms. Patient data may be entered in a format similar to the Category 4 Treatment Card, and lists similar to the Category 4 Register can then be generated. Print-outs of the list may be compared with the handwritten Category 4 Register to ensure completeness of the system. The corrected database may then be used to generate quarterly and annual reports.
Even if a computerized system is in place, a hand-written Category 4 Register should be kept, since otherwise corrections can not be seen.
BOX 18.1 Other DRTB Recording and Reporting Components/indicators
Other indicators and analysis include:
MDR-TB treatment coverage: the proportion of patients started on Category 1V treatment among the total number patients detected with MDR- TB during a defined period. This indicator is calculated from the Quarterly report on MDR-TB detection and Category 1V treatment start (Form 05). The same analysis is also done for XDR-TB.
Delay between MDR-TB detection and Category 1V treatment start. This indicator is computed separately for each treatment history group and for XDR-TB. This indicator can be calculated using data obtained from the Laboratory Register for culture and DST (Form 04) and the Category 1V Register (Form 02).
DST coverage in patient groups targeted for DST. This assessment requires comparing the number of patients in the target groups for DST to the number in whom DST has been done. Target groups for DST in Uganda include all failures of Category 1 treatment and all retreatment cases. The MDRTB Focal point should therefore regularly (monthly/quarterly) compare the names of all cat I failures and all patients who start retreatment regimens (Category 1I) to the names of patients in the lab register for DST; thereby determine the coverage of obtaining DST in this patient group.
The number of failures of Category 1 treatment. Routinely notified quarterly (challenge is R&R tools only capture numbers not names). Similarly, numbers on retreatment (not names) are notified quarterly
The number of failures of Category 1I treatment. Same as above
Percentage of MDR-TB in different patient groups. This information may be collected from the District TB Registers (if DST data are included), from the Laboratory Register for culture and DST (Form 04) or through surveys. For example, the percentage of MDR-TB in failures of Category 1 vs. failures of Category 1I vs. default vs. relapse.
Recording and reporting system and information flow through the health organization levels
1. Peripheral Heath Services: Site where the patient receive CAT IV treatment: a. Forms and instruments to be used.
i. Copy of Cat IV treatment card (Form 1) b. Update
i. Update Treatment Card daily
ii. Receive laboratory reports and update the CAT IV Treatment Card iii. In each monthly visit to be done by the patient to the District Hospital
(or the nearest heath centre with a trained medical officer), the patient and health worker and/or treatment supporter will take the CAT IV Treatment Card with them in order to update them.
c. Prepare reports
i. In each quarterly visit to be done by the patient to the Regional DR-TB referral centre, the patient and health worker and/or treatment supporter will take the CAT IV Treatment Card with them in order to facilitate the updating of CAT IV Treatment Card which remained in Regional/ National DR-TB Referral Centre where DR-TB treatment was initiated. 2. Regional DR-TB Referral Centre (Site where the patients’ treatment will be
monitored and side effects managed) a. Forms and instruments
i. Copy of Cat IV treatment card (Form 1) ii. Data base (OpenMRS shall be used). b. Update
i. Cat IV Treatment Card (Form 1) and data base in each quarterly monitoring visit by the patient at this Referral Centre.
ii. Receive laboratory reports and update the CAT IV Treatment Card and data base
a. Prepare forms and reports and send them to next level.
i. Send the actualized data base to National DR-TB Referral Centre
every quarter
3. National DR-TB Referral Centre (Where patients start treatment) a. Forms and instruments
i. Cat IV treatment card (Form 1
ii. Cat IV treatment Register
iii. Data base (Excel, OpenMRS, etc)
iv. Report on MDR-TB detection and Category 4 treatment start (Form
05)
b. Update:
v. CAT IV Treatment Card daily, when the patient remain in the hospital
vi. Cat IV register monthly, when the patients remain in the hospital.
vii. Cat IV treatment Register basing on the Data Base received from
Regional Referral Centre (Every quarter) and
viii. Data Base basing on the updated Data Base received from Regional
Referral Centre
ix. CAT IV Treatment Card and Data Bank basing on received laboratory
reports
c. Prepare forms and reports and send them to NTLP.
Prepare the Cat IV treatment card (Form 1) and send copies to Regional Referral Centre and Local Health Centre when discharge the patient from the hospital in order to continue the ambulatory treatment.
Prepare the Cat IV treatment Register and maintain it en the hospital
Prepare the Quarterly report on MDR-TB detection and Category 4 treatment start (Form 05)
Sent Quarterly report on MDR-TB detection and Category 4 treatment start (Form 05) and the actualized data base to NTLP in quarterly base.
4. NTLP
b. Forms and instruments
i. Install the Data base when possible ( OpenMRS, etc)
ii. Annual report of treatment result of confirmed MDR-TB patients
starting Category 4 treatment (Form 07)
c. Update
i. Collect the Quarterly report on MDR-TB detection and Category 4
treatment start (Form 05)
ii. Update the Data Base basing on the updated data base received from
National DR-TB Referral Centre.
iii. Receive laboratory reports of new MDR-TB cases and update the
MDR-TB list.
d. Prepare reports and send them.
i. Prepare the Annual report of treatment result of confirmed MDR-
TB patients starting Category 4 treatment (Form 07) and send it to
National Referral Centre and Regional Referral Centre
ii. Prepare periodical reports regarding the Clinical and programmatic
management of the MDR-TB cases and send it to National Referral
Centre and Regional Referral Centre
NTLP Data Base Data Base Annual report (Cohort) (F orm 7) Treatment Card National Referr al Centre Quarterly Report: detection (F orm 5) Regional Referr al Centre Quarterly Control Local Healht Center Data Base Hospital Patient Monitoringl Monthly Control Treatment Card Data Base C AT IV Registers Supervision Facilities Reports Supervision C AT IV Register
Consolidate Quarterly Report: detection (F