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Table 2 Data collection tools, sources, and outcome measures

From: Addressing challenges in scaling up TB and HIV treatment integration in rural primary healthcare clinics in South Africa (SUTHI): a cluster randomized controlled trial protocol

Data to be collected Data source Outcomes measure
TB-HIV integration indicators    Clinical outcomes
TIER.Net, community care givers, autopsy reports - Mortality rates—number of deaths among TB and HIV patients accessing care in study clinics from date clinic enrolled to 18 months post enrolment.
TIER.Net - Proportion of patients retained in care—proportion of HIV-infected patients enrolled in care at clinics and alive 12 months.
TIER.Net - Viral load testing coverage—proportion of patients on ART with viral loads test done among those eligible for viral load test at requested time points.
TIER.Net - Viral load suppression—proportion of patients with undetectable viral load tests among those receiving 12 monthly viral load test.
TIER.Net and clinic TB registers - TB treatment outcomes at end of study period—
- Cure rates: proportion of new smear-positive patients that are smear-negative in the last month of treatment and on at least one other occasion at least 30 days prior.
- Loss to follow-up rates: proportion of new smear-positive patients that interrupted TB treatment for 2 consecutive months or more.
- Treatment failure rates: Proportion of new smear-positive patients that are smear-positive at the end of TB treatment period.
- Death rate: proportion of new smear-positive patients that died during TB treatment.
- Transfer-out rate: proportion of new smear-positive pulmonary TB patients registered that were transferred to another district and for whom the TB treatment outcome is unknown.
 Process outcome
- HCT Coverage—proportion of patients with unknown HIV status tested for HIV
TIER.Net, DHIS and clinic-based registers
TIER.Net, DHIS and clinic-based registers - Co-infection—proportion of TB patients co-infected with HIV
TIER.Net, DHIS and clinic-based registers - Time to ART initiation (in days)—time in days between diagnosis of HIV infection diagnosis and ART initiation.
TIER.Net, DHIS and clinic-based registers - TB screening coverage among HIV-infected patients—
a) Proportion of HIV-infected patients receiving TB screening and
b) Frequency of TB screening during follow-up
TIER.Net, DHIS and clinic-based registers - IPT initiation—
a) Proportion of HIV-infected TB negative patients initiated on IPT and
b) Proportion of patients completing IPT course.
TIER.Net, DHIS and clinic-based registers - CPT uptake among co-infected patients—proportion of eligible HIV-positive patients initiated on CPT
TB-HIV service integration in the facility macro-environment Survey instrument developed by Uyei et al. 2014 [7] Measured TB-HIV integration in terms of:
➢ Organization—such as co-location of services, combined patient records, information management, and joint training
➢ Structure—existent practice of joint service delivery,
➢ Process—behavior and practice of delivering services
➢ Culture—work place culture and personal identification with integrated service delivery
Clinic profile tool aimed at assessing clinics’ infrastructure, capacity, and systems in place to implement TB-HIV integration services A CAPRISA designed tool - Resources inventory and needs for implementation of TB-HIV integration services, e.g., available guidelines, protocols, policies, trained staff.
- Existing quality improvement interventions, processes and measurements
- District level leadership and support
Clinic culture, leadership, resources, etc. The COACH tool designed by Bergstrom et al. 2015 [56] - Clinic leadership and support
- Staff knowledge and skills
- Perceptions of work culture at PHC
Staff Work-related Quality of Life WHO Work-related Quality of Life Scale Work-related quality of life for staff at PHC