Sputum smearnegative PTB and extrapulmonary TB patients

Four of the above standard outcome indicators are applicable to adults and children with smear-negative PTB or extrapulmonary TB. These indicators are treatment completion, death, default and transfer out, which the DTO should record in the district TB register.

Record as a treatment failure a patient who was initially smear-negative before starting treatment and became smear-positive after completing the initial phase of treatment.

9.7.3 Cohort analysis: questions and answers What is cohort analysis?

A cohort is a group of patients diagnosed and registered for treatment during a specific time period (usually one quarter of the year). For example, all the sputum smear-positive PTB patients registered from 1 January to 31 March in any year form the cohort for that quarter-year. Cohort analysis refers to the statistical breakdown of the cohort according to certain indicators. These indicators are the standardized case definitions and treatment categories (see Chapter 8) and the treatment outcomes. New and previously treated patients form separate cohorts.

Who performs cohort analysis and how often?

Cohort analysis is a continuous process. The DTO performs cohort analysis on TB patients registered in the district every quarter-year and at the end of every year.The regional TB officer performs cohort analysis on all TB patients registered in the region. The NTP central unit performs cohort analysis on all TB patients registered nationally.

What is cohort analysis for?

Cohort analysis is the key management tool used to evaluate the effectiveness of NTP performance. It enables district and regional NTP staff and the NTP directorate to identify districts with problems. Examples of problems identified include the following: low cure rate, high default rate, higher than expected proportions of sputum smear-negative PTB or extrapulmonary TB, lower than expected case detection rate. Identification of problems enables the NTP to overcome them and improve programme delivery.

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