BOTSWANA NATIONAL TUBERCULOSIS PROGRAMME ANSWER KEY – Module 9, exercise 9. 2 CLINIC TUBERCULOSIS REGISTER

Registration number
###/yy / Registration Date
dd/mm/yy / Omang/
Resident certificate /
Passport #
(If available) / Transfer In1 / Name in Full
Surname
(Upper line)
First Name
(Lower line) / Sex
M/F / A
g
e
(in years) / Physical Address
in full
(Upper line)
Alternate Address
(Lower line) / Patient Category2 / Disease Classifi-cation
P=Pulmonary
E=Extra Pulmonary
Both / Site of Extrapulmonary3 / Treatment Start Date
(Upper line)
Regimen4
(Lower Line) / Sputum Smear Results
Pre-Treatment / End of Intensive Phase
(2 months)
Date / Result5 / Date / Result5
036/05 / 05/06/05 / 123456789 / N / Maketoni
Janice / F / 34 / Plot 324, Ext. 12 / N / P / 05/06/05
2HRZE/4 HR / 30/05/05 / P+++ / 05/0805 / N
31/05/05 / P+++ / 06/08/05 / N
31/05/05 / P+++
037/05 / 25/06/05 / 987654321 / T / Matswiri
Robert / M / 22 / Plot 90210
by Shell Station / N / EP / Bone / 24/04/05
2HRZE/4 HR / 25/06/05 / P++
038/05 / 25/06/05 / 111112222 / N / Kashweka
John / M / 32 / Plot 5429
Near Village and Gym Active
Red house / N / P / 25/06/05
2HRZE/4 HR / 21/6/05 / P++
22/06/05 / P++
22/06/05 / P++
040/05 / 01/06/05 / 555666677 / N / Dintwa
Grace / F / 43 / Next door to George’s Bar
Plot 6160 / D / P / 01/06/05
2HRZE/4HR / 29/05/05 / N / 30/07/06 / P
30/05/05 / N / 01/08/06 / P
30/05/05 / N / 01/08/06 / P
041/05 / 222333678 / N / Radithalo
Thabo / M / Plot 7246 Near Main Mall, blue house / F / 2HRZE/4HR / 29/06/05 / P+
30/06/05 / P+
30/06/05 / P++
042/05 / 164778899 / N / Mbulawa
Onalenna / M / plot 8907 yellow house at cattle guard near entrance to Debswana /
1 TRANSFER IN / 2 PATIENT CATEGORY / 3 SITE OF EXTRAPULMONARY / 4 REGIMEN
N = No, newly registered / N = New: A patient who has never had treatment for TB or who has taken antiTB treatment for less than 1 month. / Lymph nodes
Pleura
T = Transfer In from facility in another district / RETREAMENT CATEGORIES / Meninges
M = Moved In from another facility in the same district / F = FAILURE: A patient who is started on a re-treatment regimen after having failed previous treatment
D = DEFAULT: A patient who returns to treatment, positive bacteriology, following interruption of treatment for 2 months or more. / Bones/joints
Miliary
R = RELAPSE: A patient previously treated for TB who has been declared cured or treatment completed, and is
diagnosed with bacteriologically positive TB. / Other sites

ANSWER KEY – Module 8, exercise 2 NAME OF DISTRICT__ Gaborone (15)______NAME OF CLINIC__ Broadhurst 1______CLINIC NUMBER __03______

Sputum Smear Results / Culture / Compliance with Treatment / HIV6
Status
(Upper line)
Test Date
dd/mm/yy
(Lower line)

Test 1 Test 2
lower)line) / Antiretroviral Therapy
(ART)
Y/N
(Upper line)
Start
Date
(Lower line) / Isoniazid Preventive Therapy
(IPT)
before TB diagnosis
Y/N / IPT Start Date
(dd/mm/yy) / TB Treatment Stop Date
(dd/mm/yy) / Outcome
of Treatment7 / Remarks
End of Treatment
(6 months) / End of Treatment
(8 months) / Month
Date / Result
P/N / 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10 / 11 / 12
/ 25
25 / 25
31 / 31
31 / 30
30 / 31
31 / 27
30 / N
2004 / N
30/05/05 / N/A / yes / C
6
6 / 28
31 / 0
31 / 30
30 / 31
31 / 6
6 / P
13/01/04 / Y
28/07/04 / N / TC
5
5 / 28
31 / 31
31 / 1
30 / P
2001 / N / Y / 02/01 / I / Defaulted September 2nd, 2005
30/10/06 / P / 30
30 / 31
31 / 28
31 / 29
30 / 30
31 / 29
30 / / N / F / 01/08/05 Specimens submitted for culture and DST. Refused HIV test
01/10/06 / P
01/10/06 / P
N / 31
31 / 28
31 / 29
30 / 30
31 / 29
30 / 31
31 / / 31/12/05 / TC
N
28/12/05 / N
5 RESULT / 6 HIV Status / 7 OUTCOME
P = Positive / P = Positive / C = CURED: Initially smear-positive patient who is smear-negative in the last month of treatment and on at least one previous occasion.
N = Negative / N = Negative / TC= TREATMENT COMPLETED: Patient who has completed treatment but does not meet the criteria to be classified as cure or a failure.
(Indicate the grading, +; ++; +++; scanty) / F = TREATMENT FAILURE: Patient who is sputum smear-positive at 5 months or later during treatment.
D = DIED: Patient who dies for any reason during treatment.
I = DEFAULTED: Patient whose treatment was interrupted for two consecutive months or more.
TO = TRANSFERRED OUT: Patient who has been transferred to another reporting district for whom treatment outcome is not known
MO = Moved Out: Patient who moved out to another facility in the same reporting unit


Answer Key Exercise 9.2

For Supervisory checklist

NOTES:

Task: All confirmed patients entered into register. Answer: This would need to be cross-checked against SSD. Not done in this exercise.

Task: patient’s Information is complete. Answer: Lots of missing data: Rating= Poor

Task: All sputum results correctly recorded. Again, this would need to be verified against SSD. However, even in looking at this register alone, you can see there are errors, for example with patients 36, 37, 40 and 41- errors include missing dates and specimens.

Task: Patient compliance correctly recorded. Answer: Satisfactory as 5/6 patients had compliance correctly recorded. It is unclear whether patient 42 should have been registered at all.

Task: End of treatment /outcome correctly recorded. Answer: 2/5 patients incorrectly had incorrectly recorded outcomes. This is almost 50% error rate! POOR!

Task: All HIV status correctly recorded. Answer: 2/5 patients with problems- one patient had no result, and one patient’s HIV status was discrepant with their IPT status. The one patient who refused is correctly recorded as HIV test refused in the remarks column. Again- POOR!

Task: IPT History Recorded correctly. Answer: One patient had no HIV or IPT recorded; and one patient was recorded as HIV-negative but had received IPT. This discrepancy needs to be checked out. (The patient that refused HIV status is correctly missing IPT)

Task: ARV status recorded correctly. Answer: ART status is not missing for either HIV-positive patient. Score = GOOD

126