TABLE 1.
Definitions of treatment outcome and adherence to follow-up among MDR/RR-TB patients started on shorter treatment regimen in Nepal, 2018–2019
| Term | Definitions |
|---|---|
| Cured | Treatment completed without evidence of failure and two consecutive negative cultures taken at least 30 days apart in the continuation phase |
| Treatment completed | Treatment completed without evidence of failure but there is no record of two consecutive negative cultures taken at least 30 days apart in the continuation phase |
| Died | A patient who dies for any reason during the course of treatment |
| Failure | A patient who has a positive culture after ⩾6 months of treatment (except for an isolated positive culture, which is a culture preceded by ⩾1 and followed by ⩾2 negative cultures); OR A patient who after an initial conversion, has a reversion after ⩾6 months of treatment with two consecutive positive cultures taken at least 30 days apart; OR Evidence of additional acquired resistance to fluoroquinolones or second-line injectables; OR Treatment terminated or need for permanent change of at least two of anti-TB drugs due to adverse drug reactions |
| LTFU | A patient whose treatment was interrupted for ⩾2 consecutive months |
| Not evaluated | A patient for whom no treatment outcome is assigned (this includes patients “transferred out” to another treatment unit and whose treatment outcome is unknown) |
| Treatment success | The sum of cured and treatment completed |
| Unsuccessful treatment outcomes | The sum of death, LTFU, failure and not evaluated |
| Relapse | Patient after completing a course of STR and declared “cured” or “treatment completed”, is diagnosed with another episode of confirmed RR-TB (based on Xpert® MTB/RIF assay or culture) during a follow-up period of 1 year post-treatment |
| Adherence to follow-up | Number of patients who had a follow-up smear or culture divided by the number eligible for follow-up for a given month; the number eligible is calculated by subtracting the number dead and LTFU before the scheduled follow-up time |
| Bacteriological effectiveness | This is calculated by dividing the number successfully treated by the number of patients who had a bacteriological outcome (excluding death, LTFU and not evaluated) |
MDR/RR-TB = multidrug-resistant/rifampicin-resistant TB; LTFU = lost of follow-up; STR = shorter treatment regimen.