SEPTEMBER 2020
OF VIRAL LOAD TESTING DATA WITHIN HIV PROGRAMMES AND PATIENT MONITORING SYSTEMS
WEB ANNEX E: TOOLS FOR RECOUNTING VIRAL LOAD TESTING INDICATORS
IMPLEMENT ATION TOOL
The objective of this tool is: (1) to understand how the site calculates the viral load (VL) coverage and suppression indicators and establish the definitions being used for these;
(2) to enable these indicators to be recalculated; and (3) to enable the verification factor to be calculated, which is a measure for comparison between recounted and reported indicators. External assessment teams are recommended to work with facility staff., such as data clerks familiar with
data systems in use, indication definitions and calculation methods to ensure that indicators are accurately verified with the required disaggregation.
Method for validating data on VL testing
Instructions for the data quality assessment team: please describe in detail the method your team used to validate each indicator.
Form 1: [COUNTRY NAME] VL indicator verification RECORDING SHEETS
1. PERCENTAGE OF PEOPLE RECEIVING ART AT LEAST 6 MONTHS WITH VL TEST RESULTS (TESTING COVERAGE)
1a. Definition of site method (how does the site collect and report this indicator?): is this different to the method used by the health ministry?
If so, how?
Definition of the site method to calculate the numerator:
Is the site method for the numerator consistent with the ministry of health method? Yes No Definition of site method to calculate denominator:
Is the site method for the denominator consistent with the ministry of health method? Yes No Overall, is the site method for this indicator consistent with the ministry of health method? Yes No 1b. Recreation of the indicator
The method used by the ministry of healtha Site method (if different to the ministry of Health method) Were you able to calculate using the method used by the ministry of health?
Yes No If no, explain:
Were you able to calculate using the site method?
Yes No If no, explain:
Which data sources did you use to calculate by the ministry of health method?
Patient medical chart ART register
Laboratory reporting forms
Electronic register or electronic medical records Laboratory information system
Other: _________________________________
Which data sources did you use to calculate by the site method?
Patient medical chart ART register
Laboratory reporting forms
Electronic register or electronic medical records Laboratory information system
Other: _________________________________
Describe how you calculated using the ministry of health method: Describe how you calculated using the site method (if it is the same as the ministry of health description above, please note that):
aThis should be the same method used by partners
Site Name Visit Date Team #
Is the site method consistent with the ministry of health method? Yes No 2b. Recreation of the indicator using site and the ministry of health method
The method used by the ministry of healtha Site method (if different to the ministry of Health method) Were you able to calculate using the method used by the ministry of health?
Yes No If no, explain:
Were you able to calculate using the site method?
Yes No If no, explain:
Which data sources did you use to calculate by the ministry of health method?
Patient medical chart ART register
Laboratory reporting forms
Electronic register or electronic medical records Laboratory information system
Other: _________________________________
Which data sources did you use to calculate by the site method?
Patient medical chart ART register
Laboratory reporting forms
Electronic register or electronic medical records Laboratory information system
Other: _________________________________
Describe how you calculated using the ministry of health method: Describe how you calculated using the site method (if it is the same as the ministry of health description above, please note that):
aThis should be the same method used by partners
Section 1 will be completed using the national site-level reported results (such as from DHIS2 or quarterly ministry of health reports) for the specific quarter of interest and using facility-level monthly aggregate results for the months that correspond to the quarter of interest.
The results from these months for the VL indicators will be directly transcribed in Tables A5.1 and A5.2.
Section 2 will be completed by recreating the VL indicators
at the site level. The data quality assessment team should work
with the health facility staff to understand what tools and
systems are being used to calculate the national VL indicators
and to replicate that process. The results from the recreated
indicators will then be used to complete Tables A5.3 and A5.4.
TABLE A5.1. DATA COLLECTION TOOL – REPORTED SITE DATA ON THE NUMBER AND PERCENTAGE OF PEOPLE RECEIVING ART FOR AT LEAST 6 MONTHS WITH VL TEST RESULTS (VL COVERAGE)
Health ministry data source(s) reviewed
Ministry of health monthly report (January 2020)
Ministry of health monthly report (February 2020)
Ministry of health monthly report
(March 2020)
Ministry of health quarterly total for Q1 in fiscal
year 2020
Partner quarterly total for Q1 in fiscal year
(if relevant)a Comments Total numerator:
number of people receiving ART with at least one routine VL test result during the reporting period Total denominator:
number of people receiving ART ≥6 months
% receiving ART
≥6 months with VL test resultsb Disaggregates
Age and sex disaggregation 0–4 years old (both sexes) numerator 0–4 years old (both sexes) denominator 0–4 years old (both sexes) % receiving ART ≥6 months with VL test results 5–9 years old (both sexes) numerator 5–9 years old (both sexes) denominator 5–9 years old (both sexes) % receiving ART ≥6 months with VL test results
Health ministry monthly reporting form: months X–Z Complete Tables A5.1 and A5.2 using the reported site-level
results from ministry of health for the selected period. Be sure to verify the correct time frame being reviewed. ministry of health results can be accessed using the ministry of health
monthly reports found at the health facility or through an alternative health ministry mechanism (a health information system such as DHIS2 if possible).
Site Name Visit Date Team #
Females 10–14 years old numerator 10–14 years old denominator 10–14 years old
% receiving ART
≥6 months with VL test results 15–19 years old numerator 15–19 years old denominator 15–19 years old
% receiving ART
≥6 months with VL test results 20–24 years old numerator 20–24 years old denominator 20–24 years old
% receiving ART
≥6 months with VL test results 25–49 years old numerator 25–49 years old denominator 25–49 years old
% receiving ART
≥6 months with VL test results 50+ years old numerator 50+ years old denominator 50+ years old
% receiving ART
≥6 months with VL test results Unknown numerator Unknown denominator Unknown
% receiving ART
≥6 months with VL test results
Ministry of health monthly report
(January 2020)
Ministry of health monthly report (February 2020)
Ministry of health monthly report
(March 2020)
Ministry of health quarterly total for Q1 in fiscal
year 2020
Partner quarterly total for Q1 in fiscal year
(if relevant)a Comments Males
10–14 years old numerator 10–14 years old denominator 10–14 years old
% receiving ART
≥6 months with VL test results 15–19 years old numerator 15–19 years old denominator 15–19 years old
% receiving ART
≥6 months with VL test results 20–24 years old numerator 20–24 years old denominator 20–24 years old
% receiving ART
≥6 months with VL test results 25–49 years old numerator 25–49 years old denominator 25–49 years old
% receiving ART
≥6 months with VL test results 50+ years old numerator 50+ years old denominator 50+ years old
% receiving ART
≥6 months with VL test results Unknown numerator Unknown denominator Unknown
% receiving ART
≥6 months with VL test results
Pregnant women Numerator Denominator
% receiving ART
≥6 months with VL test results Breastfeeding women Numerator
Denominator
% receiving ART
≥6 months with VL test results
TB-coinfected patients Numerator
Denominator
% receiving ART
≥6 months with VL test results Sex workers Numerator Denominator
% receiving ART
≥6 months with VL test results
Men who have sex with men Numerator
Denominator
% receiving ART
≥6 months with VL test results
People in prisons and other closed settings Numerator
Denominator
% receiving ART
≥6 months with VL test results
People who inject drugs Numerator
Denominator
% receiving ART
≥6 months with VL test results Transgender people Numerator
Denominator
% receiving ART
≥6 months with VL test results
aIf the site is supported by a partner, this column enables recording of the quarterly total reported to the partner.
bThe VL coverage indicator definition used in this table should be updated to align with the ministry of health indicator if this is different.
TABLE A5.2. DATA COLLECTION TOOL – REPORTED SITE DATA ON THE NUMBER AND PERCENTAGE OF PEOPLE LIVING WITH HIV RECEIVING ART (FOR AT LEAST 6 MONTHS) WHO HAVE SUPPRESSED VL
Ministry of health data source(s) reviewed
Ministry of health monthly report (January 2020)
Ministry of health monthly report (February 2020)
Ministry of health monthly report
(March 2020)
Ministry of health quarterly total for Q1 in fiscal
year 2020
Partner quarterly total for Q1 in fiscal year
(if relevant)a Comments Total numerator:
number receiving ART for ≥6 months with ≥1 routine VL test result who have suppressed VL during the reporting period Total denominator:
number receiving ART for ≥6 months with ≥1 routine VL test result in medical or lab record during the reporting period
% receiving ART (≥6 months) who have suppressed VLb
Disaggregates
Age and sex disaggregation 0–4 years old (both
sexes) numerator 0–4 years old (both sexes) denominator 0–4 years old (both sexes) % receiving ART (for at least 6 months) who have suppressed VL 5–9 years old (both sexes) numerator 5–9 years old (both sexes) denominator 5–9 years old (both sexes) % receiving ART (for at least 6 months) who have suppressed VL
Ministry of health monthly reporting form: months X–Z
Site Name Visit Date Team #
Females 10–14 years old numerator 10–14 years old denominator 10–14 years old % receiving ART (for at least 6 months) who have suppressed VL 15–19 years old numerator 15–19 years old denominator 15–19 years old % receiving ART (for at least 6 months) who have suppressed VL 20–24 years old numerator 20–24 years old denominator 20–24 years old % receiving ART ≥6 months with VL test results
25–49 years old numerator 25–49 years old denominator 25–49 years old % receiving ART ≥6 months with VL test results% receiving ART (for at least 6 months) who have suppressed VL 50+ years old numerator 50+ years old denominator 50+ years old % receiving ART (for at least 6 months) who have suppressed VL Unknown numerator Unknown denominator Unknown % receiving ART (for at least 6 months) who have suppressed VL
Ministry of health monthly report (January 2020)
Ministry of health monthly report (February 2020)
Ministry of health monthly report
(March 2020)
Ministry of health quarterly total for Q1 in fiscal
year 2020
Partner quarterly total for Q1 in fiscal year
(if relevant)a Comments Males
10–14 years old numerator 10–14 years old denominator 10–14 years old % receiving ART (for at least 6 months) who have suppressed VL 15–19 years old numerator 15–19 years old denominator 15–19 years old % receiving ART (for at least 6 months) who have suppressed VL 20–24 years old numerator 20–24 years old denominator 20–24 years old % receiving ART (for at least 6 months) who have suppressed VL 25–49 years old numerator 25–49 years old denominator 25–49 years old % receiving ART (for at least 6 months) who have suppressed VL 50+ years old numerator 50+ years old denominator 50+ years old % receiving ART (for at least 6 months) who have suppressed VL Unknown numerator Unknown denominator Unknown % receiving ART (for at least 6 months) who have suppressed VL
Pregnant women Total numerator:
Total denominator:
% receiving ART (for at least 6 months) who have
suppressed VL Breastfeeding women Numerator
Denominator
% receiving ART (for at least 6 months) who have
suppressed VL TB-coinfected patients Numerator
Denominator
% receiving ART (for at least 6 months) who have
suppressed VL Sex workers Numerator Denominator
% receiving ART (for at least 6 months) who have
suppressed VL
Men who have sex with men Numerator
Denominator
% receiving ART (for at least 6 months) who have
suppressed VL
People in prisons and other closed settings Numerator
Denominator
% receiving ART (for at least 6 months) who have
suppressed VL
People who inject drugs Numerator
Denominator
% receiving ART (for at least 6 months) who have
suppressed VL Transgender people Numerator
Denominator
% receiving ART (for at least 6 months) who have
suppressed VL
aIf the site is supported by a partner, this column enables recording of the quarterly total reported to the partner.
bThe VL suppression indicator definition used in this table should be updated to align with the ministry of health indicator if this is different.
TABLE A5.1. DATA COLLECTION TOOL – REPORTED SITE DATA ON THE NUMBER AND PERCENTAGE OF PEOPLE RECEIVING ART FOR AT LEAST 6 MONTHS WITH VL TEST RESULTS (VL COVERAGE)
If the site method differs from the national ministry of health recommended method of calculating the percentage of people receiving ART (at least 6 months) with VL test results, recount using both methods and record this in the appropriate columns.
In addition, if there is an electronic medical records system or a laboratory information management system (LIMS) but it is not used to verify the number and proportion of people with a VL result, the electronic medical records or LIMS column can be used to include these totals as an additional comparison.
The verification factor is the measure for comparison between recounted and reported indicators and is calculated as follows:
(recounted indicator/reported indicator) times 100.
Reporting period: quarter, year
Verification factor: (recounted indicator/reported indicator) times 100
Electronic medical records
(optional)
Laboratory information system (if available)
Site method
Ministry of healtha method (if different)
Comments Jan
2020 Feb 2020
Mar 2020 Total
Jan 2020
Feb 2020
Mar 2020 Total Total numerator:
number of people receiving ART with at least one routine VL test result during the reporting period Total denominator:
number of people receiving ART receiving ART ≥6 months
% receiving ART
≥6 months with VL test resultsb Pregnant Numerator Denominator
% receiving ART
≥6 months with VL test results Breastfeeding Numerator Denominator
% receiving ART
≥6 months with VL test results
Confirmed TB or TB treated Numerator
Denominator
% receiving ART
≥6 months with VL test results
Complete Tables A5.3 and A5.4 using the same methods the health facility uses for calculating the indicators (site method) when they complete the national ministry of health reporting tool and if relevant partner data collection tool.
Record the numbers recreated for each indicator in the site method section in each of the tables.
Site Name Visit Date Team #
Age and sex disaggregation 0–4 years old (both sexes) numerator 0–4 years old (both sexes) denominator 0–4 years old (both sexes) % receiving ART ≥6 months with VL test results 5–9 years old (both sexes) numerator 5–9 years old (both sexes) denominator 5–9 years old (both sexes) % receiving ART ≥6 months with VL test results Females 10–14 years old numerator 10–14 years old denominator 10–14 years old
% receiving ART
≥6 months with VL test results 15–19 years old numerator 15–19 years old denominator 15–19 years old
% receiving ART
≥6 months with VL test results 20–24 years old numerator 20–24 years old denominator 20–24 years old
% receiving ART
≥6 months with VL test results 25+ years old numerator 25+ years old denominator 25+ years old
% receiving ART
≥6 months with VL test results Unknown numerator Unknown denominator Unknown
% receiving ART
≥6 months with VL test results
Electronic medical records
(optional)
Laboratory information system (if available)
Site method
Ministry of healtha method (if different)
Comments Jan
2020 Feb 2020
Mar 2020 Total
Jan 2020
Feb 2020
Mar 2020 Total Males
10–14 years old numerator 10–14 years old denominator 10–14 years old
% receiving ART
≥6 months with VL test results 15–19 years old numerator 15–19 years old denominator 15–19 years old
% receiving ART
≥6 months with VL test results 20–24 years old numerator 20–24 years old denominator 20–24 years old
% receiving ART
≥6 months with VL test results 25+ years old numerator 25+ years old denominator 25+ years old
% receiving ART
≥6 months with VL test results Unknown numerator Unknown denominator Unknown
% receiving ART
≥6 months with VL test results
Sex workers Numerator Denominator
% receiving ART
≥6 months with VL test results
Men who have sex with men Numerator
Denominator
% receiving ART
≥6 months with VL test results
People in prisons and other closed settings Numerator
Denominator
% receiving ART
≥6 months with VL test results
People who inject drugs Numerator
Denominator
% receiving ART
≥6 months with VL test results Transgender people Numerator
Denominator
% receiving ART
≥6 months with VL test results
aThis should be the same method used by partners.
bVL coverage indicator definition used in this table should be updated to align with the ministry of health indicator if this is different.
TABLE A5.4. RECOUNTED OR VERIFIED NUMBER OF THE NUMBER AND PERCENTAGE OF PEOPLE RECEIVING ART FOR ≥6 MONTHS WHO HAVE SUPPRESSED VL
If the site method differs from the national ministry of health recommended method of calculating the percentage of people receiving ART (at least 6 months) with suppressed VL, recount using both methods and record this in the appropriate columns.
In addition, if there is an electronic medical records system or a LIMS but it is not used to verify the number and proportion of people with suppressed VL, the electronic medical records or LIMS column can be used to include these totals as an additional comparison.
The verification factor is the measure for comparison between recounted and reported indicators and is calculated as follows:
(recounted indicator/reported indicator) times 100.
Reporting period: quarter, year
Verification factor: (recounted indicator/reported indicator) times 100
Electronic medical records
(optional)
Laboratory information system (if available)
Site method
Ministry of healtha method (if different)
Comments Jan
2020 Feb 2020
Mar 2020 Total
Jan 2020
Feb 2020
Mar 2020 Total Total numerator:
number receiving ART for ≥6 months with ≥1 routine VL test result who have suppressed VL Total denominator:
number receiving ART for ≥6 months with ≥1 routine VL test result in medical or lab record
% receiving ART ≥6 months who have suppressed VLb Pregnant Numerator Denominator
% receiving ART
≥6 months who have suppressed VL Breastfeeding Numerator Denominator
% receiving ART
≥6 months who have suppressed VL Confirmed TB or TB treated Numerator
Denominator
% receiving ART
≥6 months who have suppressed VL
Site Name Visit Date Team #
Age and sex disaggregation 0–4 years old (both sexes) numerator 0–4 years old (both sexes) denominator 0–4 years old (both sexes) % receiving ART ≥6 months who have suppressed VL 5–9 years old (both sexes) numerator 5–9 years old (both sexes) denominator 5–9 years old (both sexes) % receiving ART ≥6 months who have suppressed VL Females 10–14 years old numerator 10–14 years old denominator 10–14 years old
% receiving ART
≥6 months who have suppressed VL 15–19 years old numerator 15–19 years old denominator 15–19 years old
% receiving ART
≥6 months who have suppressed VL 20–24 years old numerator 20–24 years old denominator 20–24 years old
% receiving ART
≥6 months who have suppressed VL 25+ years old numerator 25+ years old denominator 25+ years old
% receiving ART
≥6 months who have suppressed VL Unknown numerator Unknown denominator Unknown
% receiving ART
≥6 months who have suppressed VL
Electronic medical records
(optional)
Laboratory information system (if available)
Site method
Ministry of healtha method (if different)
Comments Jan
2020 Feb 2020
Mar 2020 Total
Jan 2020
Feb 2020
Mar 2020 Total Males
10–14 years old numerator 10–14 years old denominator 10–14 years old
% receiving ART
≥6 months who have suppressed VL 15–19 years old numerator 15–19 years old denominator 15–19 years old
% receiving ART
≥6 months who have suppressed VL 20–24 years old numerator 20–24 years old denominator 20–24 years old
% receiving ART
≥6 months who have suppressed VL 25+ years old numerator 25+ years old denominator 25+ years old
% receiving ART
≥6 months who have suppressed VL Unknown numerator Unknown denominator Unknown
% receiving ART
≥6 months who have suppressed VL
Sex workers Numerator Denominator
% receiving ART
≥6 months who have suppressed VL
Men who have sex with men Numerator
Denominator
% receiving ART
≥6 months who have suppressed VL
People in prisons and other closed settings Numerator
Denominator
% receiving ART
≥6 months who have suppressed VL People who inject drugs Numerator
Denominator
% receiving ART
≥6 months who have suppressed VL Transgender people Numerator
Denominator
% receiving ART
≥6 months who have suppressed VL
aThis should be the same method used by partners.
bThe VL suppression indicator definition used in this table should be updated to align with the ministry of health indicator if this is different.
