5.5 Monitoring and evaluation

Culture and microscopy results for tests performed in patients on MDR-TB treatment should be captured in the second-line TB treatment register as well as the respective laboratory registers (79). Sometimes these registers may exist as part of an electronic laboratory or patient information system, which makes it much easier for multiple users to access the data in real time and can also help to limit errors. It is important for the programme manager to assess the records in the second-line TB treatment register for completeness of testing using both culture and sputum smear microscopy, any discordance between the two modalities, and whether decisions on regimen changes or assignment of outcome are coherent (e.g. does a case have sufficient negative culture test results available to be classified as “cured”?). Performance indicators help to improve the quality of care; such indicators include contamination rates, turnaround times and proportion of culture tests done without results being recorded in the patient information system. In the case of repeated positive cultures, repeat testing for drug susceptibility or resistance is important.

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