TB Report - WCSH HMIS

Step 1 — Basic Information

Select the reporting department, month, and year before proceeding.

Department *

Month *

Year *

Step 2 — New Bacteriologically Confirmed Pulmonary TB

All new PTB+ cases detected and enrolled this reporting period by age and sex.

PTB+Number of bacteriologically confirmed New Pulmonary TB cases detected & enrolled — by age & sex

Age Group	Male	Female
0 – 4 years
5 – 9 years
10 – 14 years
15 – 19 years
20 – 24 years
25 – 34 years
35 – 44 years
45 – 54 years
55 – 64 years
≥ 65 years

Step 3 — Clinically Diagnosed P/Neg & New EPTB Cases

Both sub-sections by age and sex.

P/NegNumber of clinically diagnosed new pulmonary negative TB cases — by age & sex

Age Group	Male	Female
0 – 4 years
5 – 9 years
10 – 14 years
15 – 19 years
20 – 24 years
25 – 34 years
35 – 44 years
45 – 54 years
55 – 64 years
≥ 65 years

EPTBNumber of clinically diagnosed & bacteriologically confirmed new EPTB cases — by age & sex

Age Group	Male	Female
0 – 4 years
5 – 9 years
10 – 14 years
15 – 19 years
20 – 24 years
25 – 34 years
35 – 44 years
45 – 54 years
55 – 64 years
≥ 65 years

Step 4 — Relapse TB Cases & Re-treatment

RelapseNumber of all RELAPSE TB cases — by age & sex

Age Group	Male	Female
0 – 4 years
5 – 9 years
10 – 14 years
15 – 19 years
20 – 24 years
25 – 34 years
35 – 44 years
45 – 54 years
55 – 64 years
≥ 65 years

Re-TxTuberculosis Re-treatment cases

Treatment after Relapse — Male

Treatment after Relapse — Female

Failed — Male

Failed — Female

Lost to follow-up — Male

Lost to follow-up — Female

Others — Male

Others — Female

Step 5 — Key Populations & TB Treatment Outcomes

PopulationsNumber of notified TB cases from key affected population groups

Health Care Workers (incl. HEWs)

Diabetes

Homeless

Refugee

Sero-negative partners of PLHIV

Miners

Congregated Settings

TB Contacts

Others

OutcomesTreatment outcome — cohort of new bacteriologically confirmed PTB+ cases (same month previous EFY)

Total PTB+ cohort enrolled

Cured

Completed

Lost to follow-up

Died

Failed

Not evaluated

Moved to DR-TB Register

P/Neg OutcomesTreatment outcome — cohort of clinically diagnosed pulmonary TB (P/Neg)

Total P/Neg cohort enrolled

Completed

Lost to follow-up

Died

Failed

Not evaluated

Moved to DR-TB Register

EPTB OutcomesTreatment outcome — cohort of new EPTB cases

Total EPTB cohort enrolled

Completed

Lost to follow-up

Died

Failed

Not evaluated

Moved to DR-TB Register

Relapse OutcomesTreatment outcome — cohort of all Relapse cases

Total Relapse cohort enrolled

Cured

Completed

Lost to follow-up

Died

Failed

Not evaluated

Moved to DR-TB Register

OtherCommunity referral, HEW & PPM

Number of all forms TB cases detected registered initially referred by the community

Number of cohort TB patients (all forms) successfully treated who received HEW treatment adherence support

Total number of patients who started TB treatment in same reporting month previous year and received any HEW adherence support

Number of all forms TB cases notified with initial referral by PPM sites

Step 6 — Contact Investigation & TPT Coverage

DS-TB ContactsContacts with index bacteriologically confirmed pulmonary DS-TB cases — by age

Total contacts

0 – 4 years

5 – 14 years

≥ 15 years

DR-TB ContactsContacts with index bacteriologically confirmed DR-TB cases — by age

Total contacts

0 – 4 years

5 – 14 years

≥ 15 years

ScreenedContacts screened for TB & screened negative — by age

Age Group	DS-TB Contacts Screened	DR-TB Contacts Screened	DS-TB Screened Negative
0 – 4 years
5 – 14 years
≥ 15 years

TPT NewContacts screened negative and put on TPT — by age & regimen

0 – 4 years on TPT

5 – 14 years on TPT

≥ 15 years on TPT

3HP regimen

3RH regimen

6H regimen

TPT CohortCohort of individuals started TPT 12 months prior — by age & regimen

0 – 4 years (cohort)

5 – 14 years (cohort)

≥ 15 years (cohort)

3HP cohort

3RH cohort

6H cohort

TPT CompletionCohort of individuals completed TPT (started 12 months prior) — by age & regimen

0 – 4 years completed

5 – 14 years completed

≥ 15 years completed

3HP completed

3RH completed

6H completed

Step 7 — Molecular Testing, DST & DR-TB Cases Detected

MolecularNew & relapse TB patients initially tested using WHO recommended molecular rapid tests — by age & sex

Age Group	Male	Female
0 – 4 years
5 – 14 years
≥ 15 years

DST EvaluatedBacteriologically confirmed TB cases evaluated for drug susceptibility testing

New

Previously treated (incl. relapse)

Unknown

DST ResultTB cases with DST result for at least rifampicin

New

Previously treated (incl. relapse)

Unknown

HR-TBNumber of Hr-TB cases — by age & sex

Age Group	Male	Female
< 15 years
≥ 15 years

RR/MDR/Pre-XDR/XDRConfirmed DR-TB cases — by type, age & sex

Type / Age	Male	Female
RR only <15
RR only ≥15
MDR-TB <15
MDR-TB ≥15
Pre-XDR <15
Pre-XDR ≥15
XDR-TB <15
XDR-TB ≥15

FQ DSTDR-TB cases with DST result for fluoroquinolone

With susceptibility result

With resistant strain

Result unknown

Step 8 — DR-TB Treatment Coverage & Outcomes

Initiating CentreIs the health facility a DR-TB Treatment initiating center?

DR-TB Treatment initiating center

Hr-TB RegimenNumber of Hr-TB put on Hr-TB regimen — by HIV status & registration group

HIV Positive

HIV Negative

HIV Unknown

New

Previously treated (1st line)

Previously treated (2nd line)

Unknown

2nd LineDR-TB cases put on 2nd line treatment — by regimen, HIV status & registration group

Shorter regimen

Longer regimen

Individualised regimen

HIV Positive

HIV Negative

HIV Unknown

New

Previously treated (1st line)

Previously treated (2nd line)

Unknown

Bacterologically confirmed Pulmonary DR-TB

Bacterologically confirmed EPTB DR-TB

Clinically diagnosed DR-TB (Pulmonary & EPTB)

Interim 12moDR-TB Interim results — cohort initiated 12 months prior (same month previous year)

Total cohort DR-TB initiated on 2nd line same month previous year

Shorter regimen cohort

Longer regimen cohort

Short-term regimen cohort results (12 months):

Positive

Negative

Died

Lost to follow-up

Not evaluated

Long-term regimen cohort results (12 months):

Positive

Negative

Died

Lost to follow-up

Not evaluated

Final 24–36moDR-TB final outcomes — cohort started 24/36 months earlier

Short-term regimen cohort — 24 months earlier:

Cured

Completed

Died

Failed

Lost to follow-up

Not evaluated

Long-term regimen cohort — 24 months earlier:

Cured

Completed

Died

Failed

Lost to follow-up

Not evaluated

Long-term cohort (standardized + individualized) — 36 months earlier:

Cured

Completed

Died

Failed

Lost to follow-up

Not evaluated

Step 9 — Malnutrition Screening & TB/HIV Co-infection

MalnutritionMalnutrition screening for DS-TB & DR-TB cases

Category	Normal	MAM	SAM
DS-TB cases screened
DR-TB cases screened

TB/HIV+New & relapse TB patients with documented HIV positive result — by age & sex

Age Group	Male	Female
< 15 years
≥ 15 years

TB/HIV-New & relapse TB patients with documented HIV negative result — by age & sex

Age Group	Male	Female
< 15 years
≥ 15 years

On ARTHIV-positive new & relapse TB patients already on ART — by age & sex

Age Group	Male	Female
0 – 4 years
5 – 14 years
≥ 15 years

New ARTNewly tested HIV positive TB patients who began ART — by age & sex

Age Group	Male	Female
0 – 4 years
5 – 14 years
≥ 15 years

Step 10 — Leprosy, AFB & GeneXpert / LF-LAM

Complete all remaining fields then submit the report.

Leprosy NewNew leprosy cases detected (MB + PB)

Total new leprosy cases detected (MB + PB)

New PB cases:

Age	Male	Female
<15 years
≥15 years

New MB cases:

Age	Male	Female
<15 years
≥15 years

Leprosy OtherRelapse, retreatment & contacts

Total relapse leprosy cases

Retreatment cases (other than relapse)

Household contacts registered

Household contacts screened

Contacts diagnosed with leprosy

Grade IINew leprosy cases with Grade II disability (MB+PB) — by age & sex

Age	Male	Female
<15 years
≥15 years

Leprosy CohortTreatment completion — new leprosy cohort registered 16 months prior

Registered cohort of MB cases

Treatment completed MB cases

Registered cohort of PB cases

Treatment completed PB cases

AFBTotal AFB tests performed & positive — by method

Total AFB tests performed

Ziehl-Neelsen performed

Fluorescent performed

Total AFB positive

Ziehl-Neelsen positive

Fluorescent positive

GeneXpertTotal GeneXpert MTB/RIF/Ultra tests for MTB detection

Total GeneXpert tests performed

MTB Detected, Rif Resistance NOT detected

MTB Detected, Rif Resistance DETECTED

MTB Not Detected

Others (Error, Invalid, No Result)

LF-LAMLF-LAM assay tests

Total LF-LAM tests

Positive

Negative