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Root Cause Analysis of Low Performance in Percentage of Target TB Notification Achieved

Low performance means notification of TB cases is not happening as desired.

Data is available in Ni-kshay and analysed in terms of: 

The Senior Treatment Supervisor (STS) interacts with the patient care ecosystem from the time a TB case is notified, diagnosed and anti-TB treatment is initiated.

The key interactions include:

After exposure to infective droplets containing M.TB, only a small proportion gets infected and further progresses to active TB disease.

Culture Drug Susceptibility Testing (CDST) is a growth-based phenotypic method used to check the susceptibility of Mycobacterium tuberculosis strains to various first and second line anti-TB drugs. Mycobacterial resistance to a particular drug is identified if there is growth observed in culture in presence of that drug.

Screening for active tuberculosis (TB) a process to filter out people who are less likely to have TB, from a group. Screened positive people are likely to have TB and are confirmed subsequently using a TB diagnostic test. This will allow finite diagnostic testing resources to be used on the remaining.

Patient Identifiers are key for identifying a patient in the Nikshay. Ideally, there should be only one identifier for each patient which identifies patient as well as processes for lifetime. However, during the continuum of care, one identifier may not be appropriate to represent the episodes and other processes. Hence there are various ids which are tagged to one patient in Nikshay. Knowing each ID and its purpose is therefore important. The various IDs that are present in Nikshay and their purpose are described below:

Nikshay being the final updated repository of information of TB patient services, different roles perform various actions on the patient and TB service information in Nikshay and keep it updated. These roles range from health volunteers and treatment supporters on the field to health providers and doctors at health facilities. Each role acts on or inputs information based on the services he/she provides. The information is required to updated when it is generated by the person generating it (eg by the CBNAAT LT once the results of a CBNAAT test is available). 

What is the "continuum of TB Care"?