Monitoring of ACF campaign

Monitoring should be an integral part of the Active Case Finding (ACF) interventions. It is accomplished by a strong data collection system enacted through a programme-based ACF data and recording in Nikshay.

Monitoring activities for ACF interventions broadly cover the number screened, number of presumptive TB cases based on symptoms or chest X-ray findings, samples collected for testing, samples transported for testing, samples tested, microbiologically and clinically diagnosed TB cases, TB notification and treatment initiation.

Monitoring Against the ACF Plan

1. Monitor the Number Needed to Screen (NNS), i.e., the number needed to be screened based on current TB symptoms, past history of TB, comorbidities, other socio-economic factors, etc. 

2. Monitor the Number Needed to Test (NNT) which helps understand the efficiency of diagnostic testing and the efficiency of screening for presumptive TB.

3. Monitor the yield of ACF activities, i.e., TB cases found and compare the yield of different screening and testing methods (X-ray, smear, Nucleic Acid Amplification Test (NAAT)).

4. Monitor whether there was an additional increase in TB notification of bacteriologically confirmed TB cases compared to the previous year (or in comparison to a control district).

• Monitor notification trends, treatment outcomes and mortality (TB prevalence should decrease over years based on repeated ACF in the same population).

5. Monitor engagement of National TB Elimination Programme (NTEP) staff, non-governmental organisations, community volunteers and the private sector in ACF activities.

Monitoring Against the Cascade of Care

1. Monitor the proportion of people with presumptive TB who provide sputum.

2. Monitor linkage to health facilities, sample collection, transportation and tests done.

3. Monitor drop-outs between screening and diagnosis, dropouts between diagnosis and treatment.

4. Monitor public health action provided to notified TB cases.

Resources

• Optimizing Active Case Finding for Tuberculosis, 2021. 
• Training Module (1-4) for Programme Managers and Medical Officers, NTEP, MoHFW, 2020.

Assessment