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Goal

Goal To discuss and refine current definitions of cases and treatment outcomes for non MDR-TB and MDR-TB, especially in anticipation of widespread use of Xpert MTB/RIF Objectives To review and propose refinements to current case definitions for non MDR-TB and MDR-TB (Day 1)

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Goal

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Presentation Transcript

  1. Goal • To discuss and refine current definitions of cases and treatment outcomes for non MDR-TB and MDR-TB, especially in anticipation of widespread use of Xpert MTB/RIF • Objectives • To review and propose refinements to current case definitions for non MDR-TB and MDR-TB (Day 1) • To review and propose refinements to current definitions of treatment outcomesfor non MDR-TB and MDR-TB (Day 2) • Expected Outcomes • Agreement on a proposed set of case and treatment outcome definitions, and steps required to adopt these definitions, for consideration by WHO's Strategic and Technical Advisory Group for TB (STAG-TB) in June 2011

  2. Key points, Day 1 • We are not defining how cases will be classified on patient cards (etc.) BUT rather how they will be categorized for the purposes of paper-based (quarterly?) reports and hence surveillance at national and global level (with ERR can aggregate/disaggregate as necessary) • Need to keep things simple (no more than current 36 categories) • Dropped "possible" and "probable categories", "probable" (sm+) merged into "confirmed" and "possible" becomes "not confirmed • Language translates more easily (also simpler) • Support for "treatment change" category • Implicitly (explicitly?) dropping the sm+ category and the distinction between pulmonary and extrapulmonary cases but HIV status and data on children among "non-confirmed cases" must be captured • Questions: • how to capture C+ given delays in culture results, link to drug orders • Group not in favour of dropping "completed treatment" outcome category – need to look again at categories (and associated definitions) as neither Option 1 nor Option 2 retained this category

  3. New and recurrent cases: (incident cases) 16 sub-categories ("boxes" in paper-based quarterly report) Includes C+, Sm+, WRD+

  4. Treatment change: (prevalent cases) 8 sub-categories ("boxes" in paper-based quarterly report)

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