Methods: Monitoring the detection and treatment of TB cases
Presentation of data
Data on policy and strategy are collected for both DOTS and non-DOTS areas separately; Annex 2 shows which of the 4 technical components of the DOTS strategy are in place in each country. Numbers of TB cases are collected in terms of site of disease, history, and sputum smear status, but this report focuses on total and new smear-positive cases. All cases notified since 1980 are shown in Annex 2, together with new smear-positive cases notified since 1995. By convention, WHO does not include retreatment cases in the calculation of TB notification rates, assuming that these episodes of disease have been registered and reported during their first round of treatment. An exception is made for relapses, which may represent new episodes of disease, the previous episode of disease having been declared cured.
In Annex 2, for European countries only, there is a column for "EURO total" cases. European countries consider these numbers to be the total cases notified. They may differ from the total notifications reported by WHO because, by European convention, all types of TB cases are included in the notification rate, not just new and relapse cases.
We ask for a breakdown of cases by age and sex for new smear-positive cases only, and these numbers, as well as age- and sex-specific rates per capita, are shown in Annex 2. Annexes showing data by region and by country also show "laboratory-confirmed" cases; these are new pulmonary cases; that were smear-positive or culture-positive.
Treatment outcomes are collected according to six mutually exclusive outcome categories (Table 2). Outcomes are collected for new smear-positive cases (by strategy, DOTS or non-DOTS) and for all retreatment case types combined (also by strategy). However, only the DOTS retreatment outcomes are shown in Annex 2. This report presents treatment outcomes for 2001. The assessment of outcomes always lags by 1 year to ensure that all patients have completed treatment. A DOTS country must report treatment outcomes, unless it is newly-classified as DOTS, in which case it would take an additional year to report outcomes from the first cohort of patients treated.
Special circumstances surrounding the data submitted by some countries (e.g. additional breakdown of cases of interest, late-reported data, reasons for incomplete data) are mentioned in the "country notes" in Annex 2.