/**
* Library: HIV.IND.48 Logic
* Ref No: DFT.1
* Short Name: TB screening coverage among new ART patients
*
* Definition: % of people living with HIV newly initiated on ART who were screened for TB
*
* Numerator: Number of people living with HIV newly initiated on ART who were screened for TB during the reporting period | | "Newly initiated" is defined as the number of people living with HIV who start ART in accordance with national treatment guidelines during the reporting period.
* Numerator Calculation: COUNT of clients with "HIV status"='HIV-positive' AND with "ART start type"='First-time user of ART' AND with "ART start date" in the reporting period AND "TB screening date" in the reporting period
* Numerator Exclusions:
*
* Denominator: Number of people living with HIV who newly initiated ART during the reporting period
* Denominator Calculation: COUNT of clients with "HIV status"='HIV-positive' AND with "ART start type"='First-time user of ART' AND with "ART start date" in the reporting period
* Denominator Exclusions:
*
* Disaggregations:
* • Gender (female, male, other*)
* • Age (0–4, 5–9, 10–14, 15–19, 20–24, 25–49, 50+ years)**
* • Cities and other administrative regions of epidemiologic importance
*
* Disaggregation Elements: Gender | Age
*
* Numerator and Denominator Elements:
* ART start date
* ART start type
* HIV status
* TB screening date
*
* Reference: Consolidated guidelines on person-centred HIV strategic information: strengthening routine data for impact. Geneva: World Health Organization; 2022
*
* Data Concepts:
* HIV.A.DE17: Age | Calculated age (number of years) of the client based on date of birth
* HIV.A.DE18: Gender* | Gender of the client*
* HIV.A.DE19: Female | Client identifies as female
* HIV.A.DE20: Male | Client identifies as male
* HIV.A.DE21: Transgender male | Client identifies as transgender male
* HIV.A.DE22: Transgender female | Client identifies as transgender female
* HIV.A.DE23: Other | Additional category
* HIV.B.DE72: ART start date | The date on which the client started or restarted antiretroviral therapy (ART)
* HIV.B.DE115: HIV status | HIV status reported after applying the national HIV testing algorithm. No single HIV test can provide an HIV-positive diagnosis.
* HIV.B.DE116: HIV-positive | Client is HIV-positive
* HIV.B.DE117: HIV-negative | Client is HIV-negative
* HIV.B.DE118: Unknown | Client has unknown HIV status
* HIV.D.DE39: ART start date | The date on which the client started or restarted ART
* HIV.D.DE43: ART start type | Whether the client is ART naive or is restarting ART
* HIV.D.DE44: First-time user of ART | Client is ART naive, having never taken ART to treat HIV before
* HIV.D.DE45: Restarting ART | Client is restarting ART after stopping treatment for any reason
* HIV.D.DE990: TB screening date | Date the TB screening was conducted
* HIV.SRV.DE6: ART start date | The date on which the client started or restarted antiretroviral therapy (ART)
*
* Additional Context
* - what it measures: This indicator measures the extent to which people living with HIV newly initiated on ART are screened for active TB disease.
* - rationale: • Routine TB screening among people living with HIV newly initiated on ART and those who are already on ART is essential to identifying presumptive TB cases in need of confirmatory diagnostic testing and to determine eligibility for TPT if active TB disease is ruled out. | • Screening is most critical at the time of ART initiation, when immune compromise is greatest. It is most commonly done as a part of pre-treatment clinical assessment. | • It is important to understand the cascade from ART enrolment to treatment of active TB disease; this indicator will highlight any obstacles between ART enrolment and screening for TB symptoms. | • This is the first of five "screening cascade" indicators considered priority for high burden TB/HIV settings.
* - method: For the numerator and denominator: Programme records (for example, ART registers, EMR)
*
* Suggested Scoring Method: proportion | http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm
*/
library HIVIND48Logic
// Included Libraries
using FHIR version '4.0.1'
include HIVCommon version '0.0.1' called HIC
include FHIRHelpers version '4.0.1'
include WHOCommon called WCom
include HIVElements called HE
include HIVIndicatorElements called HIE
// Indicator Definition
parameter "Measurement Period" Interval<Date> default Interval[@2023-01-01, @2023-01-30]
context Patient
/* Populations */
/*
*Initial Population
*/
define "Initial Population":
true
/**
* Numerator
*
* Definition: Number of people living with HIV newly initiated on ART who were screened for TB during the reporting period | | "Newly initiated" is defined as the number of people living with HIV who start ART in accordance with national treatment guidelines during the reporting period.
* Calculation: COUNT of clients with "HIV status"='HIV-positive' AND with "ART start type"='First-time user of ART' AND with "ART start date" in the reporting period AND "TB screening date" in the reporting period
*/
define "Numerator":
HIE."Has HIV-positive Status"
and (start of HE."First On ART".effective.toInterval() during "Measurement Period")
and HIE."First-time user of ART"
and HIE."TB screening date"
/**
* Denominator
*
* Definition: Number of people living with HIV who newly initiated ART during the reporting period
* Calculation: COUNT of clients with "HIV status"='HIV-positive' AND with "ART start type"='First-time user of ART' AND with "ART start date" in the reporting period
*/
define "Denominator":
HIE."Has HIV-positive Status"
and (start of HE."First On ART".effective.toInterval() during "Measurement Period")
and HIE."First-time user of ART"
/* end Populations */
/*
* Disaggregators
*/
define "Administrative Gender Stratifier":
HIE."By Administrative Gender Stratifier"
define "Age Stratifier":
HIE."By Age Stratifier"
define "Geographic Region Stratifier":
HIE."By Geographic Region Stratifier"
define "Stratification":
HIE."By Administrative Gender Stratifier".code
+ ':' + HIE."By Age Stratifier"
+ ':' + HIE."By Geographic Region Stratifier"
|