Reporting of hiv data: overview

1. Reporting of hiv data: overview

2. HIV REPORTING Data sets QUARTERLY ART COHORT REPORTING MONTHLY HIV REPORTING (cross sectional) webDHIS Integrated instance webDHIS Quarterly ART instance TIER.NET (only) PAPER TIER.NET HTS, ART FACILITY STEPS FACILITY STEPS FACILITY STEPS SUB-DISTRICT STEPS SUB-DISTRICT STEPS

3. Reporting of hiv data: Quarterly art data

4. HIV REPORTING Data sets QUARTERLY ART COHORT REPORTING MONTHLY HIV REPORTING (cross sectional) webDHIS Integrated instance webDHIS Quarterly ART instance TIER.NET (only) PAPER TIER.NET FACILITY STEPS FACILITY STEPS FACILITY STEPS SUB-DISTRICT STEPS SUB-DISTRICT STEPS

5. ART quarterly reporting • ART quarterly reporting is cohort-based. • Cohort data includes baseline data, e.g.: • Patient demoraphics. • Immunological status, etc. • Cohort data also includes outcome data, e.g.: • Programme quality indicators at different time points. • Cumulative retention in care / LTF / RIP etc. • Responses to treatment. • Clinical outcomes can be compared between facilities, (sub-) districts, and provinces.

6. ART Quarterly Data Elements: Baseline • CD4 100 to 199 (adults) or 20% TLC (paeds) at baseline • CD4 200 to 349 (adults) or 25% TLC (paeds) at baseline • CD4 350 to 499 (adults) or 30% TLC (paeds) at baseline • CD4 over 499 (adults) or over 30% TLC (paeds) at baseline • ART screen for TB at baseline (TBS) • ART on TB treatment at baseline (TBT) • ART experienced started ART (EXP) • ART - Naïve start ART (TOT) • ART adult male naïve start • ART adult female naïve start • ART child <1yr naïve started ART • ART child 1-5yrs naïve started ART • ART child 5-15yrs naïve started ART • ART on INH prevention therapy at baseline (IPT) • ART on Co-trimoxazoleprevention therapy at baseline (CPT) • ART CD4 below 100 (adults) or 15% TLC (paeds) at baseline

7. ART Quarterly Data Elements: Over time • At 3, 6, 12, 18, 24, 36 etc. months: • ART on first-line regimen (FLR) • ART on second-line regimen (SLR) • ART on third-line regimen (TLR) • ART stopped (STO) • ART Lost to follow up (LTF) • ART Died (RIP) • ART Transferred out (TFO) • ART Transferred in (TFI) • ART Viral load done (VLD) • ART Viral load <400 copies/mL (VLS) • Pregnant at ART start remaining in care at 12 months (RIC)

8. Timelines for reporting quarterly ART data • Each cohort is reported 3 months after the close of a quarter. • This allows for all activities to be completed, e.g. confirmation of outcomes, capturing of laboratory results. In this case, “reporting date” = date for submitting TIER.Net dispatch to SD.

9. Reporting of hiv data: Quarterly art data – from tier.net

10. HIV REPORTING Data sets QUARTERLY ART COHORT REPORTING MONTHLY HIV REPORTING (cross sectional) webDHIS Integrated instance webDHIS Quarterly ART instance TIER.NET (only) PAPER TIER.NET FACILITY STEPS FACILITY STEPS FACILITY STEPS SUB-DISTRICT STEPS SUB-DISTRICT STEPS

11. Ensuring data quality prior to reporting FACILITY RESPONSIBILITY: • Facilities must run and action the line lists in TIER.Net prior to monthly / quarterlyreporting, to ensure: • Defaulting patients are traced and recalled. • Clinicianstake action for all patients on the lists, so that all lists are ‘zeroed-out’. • Capturing backlogs are addressed. • Data is cleaned. • Facility Manager is responsible for ensuring the above is completed.

12. TIER.Net line lists to be actionedprior to reporting • TB case identification results outstanding list • Waiting list for TB treatment • DS-TB Cases Requiring Action (Non-conversion) list • DS-TB Conversion Sputa Required list • DS-TB Discharge Sputa Required list • TB Missed Appointment and Unconfirmed LTF list • TB Outstanding Outcomes list • Data Validation list • ART Regimen Line Validation list • Awaiting ART list • Viral Load Due list • HIV Missed Appointment and Unconfirmed LTF list Also review the TIER.Net Facility Management Report, as a quick snapshot of data that requires attention.

13. Data review prior to reporting FACILITY RESPONSIBILITY: • Facilities must generate and review the “Quarterly ART Report – Interpreted”. • Facility Manager to review and verify the key indicators, and sign the report. • Signed copy to be stored in facility TIER.Net binder. • The Quarterly ART Report displays aggregate data per cohort, and can be generated as: • Standard – provides absolute values. • Interpreted – provides percentages for certain fields. • NEW: Women who initiated ART during pregnancy.

14. Producing the Quarterly ART Interpreted Report (1) • Click on Analysis, then • HIV reports • Select Quarterly ART report

15. Producing the Quarterly ART Interpreted Report (2) • Select date when clinic started rendering ART services, until the last date of reporting quarter. • SelectInterpreted Report • SelectNew Only • ClickOK

17. Submitting TIER.Net dispatches FACILITY RESPONSIBILITY: • Facilities must submit a TIER.Net dispatch to sub-district. • Dispatches are data files for transferring patient-level data to the next higher level (facility to (sub)district and province). • Dispatches include both TB and HIV patient data. • Dispatches must be submitted quarterly, by the 5th of the relevant month. • Dispatches must be generated between 1st and 5th, to ensure data are complete up to end of the quarter.

18. Steps to run a dispatch 1 Clickon the name of the facility for which a dispatch needs to be created. 1. Click on File in the menu bar. 2. Click on Create Dispatch. 2 3: Click OK. 3 4: Select the location to save the file in and let the process run. 4 5: Click OK. 5

19. Actions prior to exporting data from TIER.Net to webDHIS (SUB)DISTRICT RESPONSIBILITY: • Sub-districts must maintain a complete TIER.Net database for the sub-district, by loading all quarterly dispatches from all implementing facilities into a consolidated TIER.Net database. • Use the (Sub) District TIER.Net Management Report to: • Confirm that all dispatches have been received and loaded. • Ensure all facilities are on TIER.Net version 1.10.5.

20. Generating the (Sub) District TIER Management Report • Click on Analysis • Choose(Sub)District TIER.Net Management Report • Check that all facilities are on version 1.10.5 • To ensure the data reported is recent; check the “Facility dispatch creation date”, and check the “Last captured visit date”.

21. Exporting data from TIER.Net to webDHIS NOTE: Export and import can be done for the entire sub-district in one go. (SUB)DISTRICT RESPONSIBILITY: • Using the up-to-date and complete sub-district TIER.Net database, sub-district must: • Produce “DHIS ART Export” files from TIER.Net, • And import these files into webDHIS. • To be completed by 10th of Jan/Apr/Jul/Oct. NOTE: Export and import must NOT be done at facility level. • Export used to be a CSV for DHIS 1.4. It is now an XML for webDHIS.

22. Producing “DHIS ART Export” file from TIER.Net (1) • Click on File, then • SelectDHIS ART export • ChooseExport Type “Quarterly, monthly and pregnancy data (XML)” • ClickOK

23. Producing “DHIS ART Export” file from TIER.Net (2) • Choose a folder to save the export in. • If no folder is chosen, the export will save in the default export folder on the C drive, under TIER program data.

24. Locating the “DHIS ART export” file • If the export file was saved in the default export folder on the C drive, under TIER program data, then • Click on Help in TIER.Net • SelectLinks, • Chose ‘Open Exports Folder’

25. Importing “DHIS ART Export” file into webDHIS SUB-DISTRICT RESPONSIBILITY: • (Sub)district HIS/IM must import the “DHIS ART Export” file from TIER.Net into webDHIS. • This must be completed by the 10th of Jan / Apr / Jul / Oct. NOTE: (Sub)district HIS/IM must be registered as webDHIS user with importing and reporting user roles.

26. Steps to import “DHIS ART Export” file into webDHIS (1) SUB-DISTRICT RESPONSIBILITY: • Locate the original “DHIS ART Export” file. • This is a 7z file, named “…CombinedQuarterly”

27. Steps to import “DHIS ART Export” file into webDHIS (2) • Extract this “…CombinedQuarterly.7z” file, to obtain 3 further zipped files: • Monthly ART data. • Quarterly ART cohort data for adults and children. • Quarterly ART cohort data for pregnant women up to 12 month duration.

28. Steps to import “DHIS ART Export” file into webDHIS (3) NOTE: the Monthly.xml must NOT be used at this stage. The webDHIS import app to receive the monthly data has only recently been developed, and is still being piloted. • Extract / unzip to obtain XML files for: • Quarterly.xml • Pregnant12M.xml

29. Steps to import “DHIS ART Export” file into webDHIS (4) • Import to ART instance at https://art.dhis.dhmis.org/ • (Data will be included in provincial instance, once stabilised.) • Click on Search apps on the dashboard page, and start typing ART Import. • Click on ART Import app.

30. Steps to import “DHIS ART Export” file into webDHIS (5) • The following screen opens. • Choosethe Quarterly.xml file and ClickImport.

31. Steps to import “DHIS ART Export” file into webDHIS (6) • The following message will appear once successfully imported: Note: the reference to “JSON” is standard for all imports in webDHIS, and can be ignored. Important: check that “Display Import Summary” has a green tick for “Import Done”.

32. Steps to import “DHIS ART Export” file into webDHIS (7) • An error message will appear if there are missing data, e.g. facility codes. • In case of error, (sub)district must send the XML to HISP Prov Data Manager to investigate.

33. Steps to import “DHIS ART Export” file into webDHIS (8) • Repeat the same steps to import the Pregnant12M.xml. • NOTE: both the Quarterly.xml as well as the Pregnant12M.xml need to be imported.

34. Dashboards • Pivot tables for the last 12 quarters are available on the dashboards: • Per duration (baseline, after 3/6/12/etc months) • For data elements and indicators • For adults and children • National and Provincial level • Users can adapt existing dashboard reports, or create their own. • DATA IS ONLY VALUABLE IF IT IS USED.

35. Questions?