Title: HIV.IND.51 Logic Id: HIVIND51Logic Version: 0.4.4 Url: HIV.IND.51 Logic Status: draft Experimental: true Type: system: http://terminology.hl7.org/CodeSystem/library-type code: logic-library Date: 2025-12-10 09:22:27+0000 Publisher: WHO Description: % of people living with HIV newly initiated on ART and tested for TB who are diagnosed with active TB disease Related Artifacts: Dependencies http://smart.who.int/hiv/Library/HIVCommon|0.0.1 WHOCommon HIVElements HIVIndicatorElements Parameters: Name Type Min Max In/Out Measurement Period Period 0 1 In Patient Patient 0 1 Out Initial Population boolean 0 1 Out Numerator boolean 0 1 Out Denominator boolean 0 1 Out Administrative Gender Stratifier Coding 0 1 Out Age Stratifier string 0 1 Out Geographic Region Stratifier string 0 1 Out Stratification string 0 1 Out Content: text/cql /** * Library: HIV.IND.51 Logic * Ref No: DFT.4 * Short Name: TB diagnosis among those tested for TB * * Definition: % of people living with HIV newly initiated on ART and tested for TB who are diagnosed with active TB disease * * Numerator: Number of people living with HIV newly initiated on ART who were diagnosed as having active TB disease * 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 AND "TB screening result"='Screen positive for TB' AND a "TB diagnostic test category" is NOT NULL AND with a "TB diagnostic test date" in the reporting period AND "Date of TB diagnosis" in the reporting period * Numerator Exclusions: * * Denominator: Number of people living with HIV who newly initiated ART and screened positive for TB symptoms who had appropriate diagnostic testing 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 AND "TB screening date" in the reporting period AND "TB screening result"='Screen positive for TB' AND a "TB diagnostic test category" is NOT NULL AND with a "TB diagnostic test 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 * * Note: This indicator is related to but distinct from indicator TB.4 Percentage of people living with HIV newly initiated on ART who have active TB disease. * * Disaggregation Elements: Gender | Age * * Numerator and Denominator Elements: * ART start date * ART start type * Date of TB diagnosis * HIV status * TB diagnostic test category * TB diagnostic test date * TB screening date * TB screening result * * 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.DE952: Date of TB diagnosis | The date when the diagnosis was established * HIV.D.DE986: TB screening result | Record the result of the tuberculosis (TB) screening * HIV.D.DE987: Screen positive for TB | Screening result was positive for tuberculosis (TB) * HIV.D.DE988: Screen negative for TB | Screening result was negative for tuberculosis (TB) * HIV.D.DE989: Inconclusive | Screening result was inconclusive for tuberculosis (TB) * HIV.D.DE990: TB screening date | Date the TB screening was conducted * HIV.D.DE992: TB diagnostic test category | The type of diagnostic test performed to detect tuberculosis (TB) disease * HIV.D.DE993: LF-LAM | Client tested for tuberculosis with a lateral flow urine lipoarabinomannan assay * HIV.D.DE994: mWRD test for TB | Client tested with a WHO-recommended molecular diagnostic test to detect Mycobacterium tuberculosis (MTB) * HIV.D.DE995: Microscopy - Sputum acid-fast bacilli (AFB) | Client tested for tuberculosis with a sputum acid-fast bacilli (AFB) * HIV.D.DE996: TB Culture | Client tested for tuberculosis (TB) with a culture * HIV.D.DE997: TB diagnostic test date | The date when TB diagnostic test was performed * 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 percentage of people living with HIV newly initiated on ART and, having screened positive for active TB disease, were evaluated and/or had appropriate TB diagnostic testing and were confirmed to have active TB disease. * - rationale: • Appropriate TB diagnostic testing based on national clinical/WHO guidelines is essential for people living with HIV who screen positive for TB. | • It is important to understand the cascade from ART enrolment to treatment of active TB disease; this indicator will highlight any obstacles between diagnostic testing and TB diagnosis. | • This is the fourth of five "screening cascade" indicators considered priority for high burden TB/HIV settings. * - method: "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. | For the numerator: Programme records (for example, ART registers, EMRs) | For the denominator: Programme records (for example, ART registers, EMRs) * * Suggested Scoring Method: proportion | http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm */ library HIVIND51Logic // 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 diagnosed as having active TB disease * 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 AND "TB screening result"='Screen positive for TB' AND a "TB diagnostic test category" is NOT NULL AND with a "TB diagnostic test date" in the reporting period AND "Date of TB diagnosis" in the reporting period */ define "Numerator": HIE."Has HIV-positive Status" and (start of First(HE."First-time user of ART").effective.toInterval() during "Measurement Period") //related the two since we want a positive observation from a specific diagnostic test. and exists( HE."TB diagnostic test category" P with HE."Screen positive for TB" O such that P.partOf.references(O) where P.performed.toInterval() during "Measurement Period" ) and HIE."Date of TB diagnosis" /** * Denominator * * Definition: Number of people living with HIV who newly initiated ART and screened positive for TB symptoms who had appropriate diagnostic testing 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 AND "TB screening result"='Screen positive for TB' AND a "TB diagnostic test category" is NOT NULL AND with a "TB diagnostic test date" in the reporting period */ define "Denominator": HIE."Has HIV-positive Status" and (start of First(HE."First-time user of ART").effective.toInterval() during "Measurement Period") //related the two since we want a positive observation from a specific diagnostic test. and exists( HE."TB diagnostic test category" P with HE."Screen positive for TB" O such that P.partOf.references(O) where P.performed.toInterval() during "Measurement Period" ) /* end Populations */ /* * Disaggregators */ define "Administrative Gender Stratifier": HIE."By Administrative Gender Stratifier" define "Age Stratifier": HIE."By Age Stratifier 2" define "Geographic Region Stratifier": HIE."By Geographic Region Stratifier" define "Stratification": HIE."By Administrative Gender Stratifier".code + ':' + HIE."By Age Stratifier 2" + ':' + HIE."By Geographic Region Stratifier" Content: application/elm+xml Encoded data (61260 characters) Content: application/elm+json Encoded data (105488 characters)
% of people living with HIV newly initiated on ART and tested for TB who are diagnosed with active TB disease