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GxAlert Monitors and Reduces High Testing Error Rates in Nigeria's GeneXpert Machine


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Presentation on the use of SystemOne's GxAlert tool in Nigeria, for monitoring reducing diagnostic errors and accelerating positive outcomes in TB.

Published courtesy of Kehinde Jimoh Agbaiyero, Senior Technical Advisor - TB, Abt Associates

Published in: Health & Medicine
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GxAlert Monitors and Reduces High Testing Error Rates in Nigeria's GeneXpert Machine

  1. 1. GxAlert SMS Improves Patient Enrollment and Management in Nigeria 46th Union World Conference on Lung Health Cape Town, South Africa Kehinde Jimoh , MD 5 December 2015
  2. 2. Abt Associates Outline  Session Objectives  Background  Approach and Process of Using GxAert  Value of integrating the GxAlert application  Implementation of Innovation  Results  To share Lessons Learned
  3. 3. Abt Associates Session Objectives  To orient participants to the technology-supported GxAlert system in Nigeria.  To present improvements in DR-TB patient enrollment.  To share lessons learned to date.
  4. 4. Abt Associates Background  Nigeria is a Country in W/Africa with a population of 165 million  Nigeria is ranked 13th among the 27 high DR-TB burden countries in the world  Prevalence of MDR-TB among New Cases is 2.9%  Prevalence of MDR-TB among Retreatment Cases is 14.3%  Number of GeneXpert Site is 151 presently  Nigeria is implementing technology- supported GxAlert system to improve DRTB patients notification and enrollment in about 60 Labs.
  5. 5. Abt Associates Challenges to Intervention  Reporting TB testing results is a lengthy process due to a continued reliance on paper records and slow data transit systems.  Quality of results data is often poor and subsequent program management decisions are not always timely or focused on priority needs.
  6. 6. Abt Associates Why Connect GeneXperts? Connected via GxAlert
  7. 7. Abt Associates What is GxAlert? GeneXpert Health Systems Connects the device via secure network. Allows automatic real-time reporting of test results. Routes the information so it can become “actionable” within the health system. Open-Source Software Source Code Available for free Any funded development available to all users/countries
  8. 8. Abt Associates Approach and Process of GxAert  GxAlert is configured on GeneXpert systems by installing a modem from a telecom that encryps and gives access to internet to send GeneXpert MTB/RIF diagnostic results in real time to a secure web- based database in mere seconds  GXAlert is a real time online database. Data can be analyzed and aggregated by: Cartridge, Module, Device, Facility, LGA, or State.  The system then sends the results in an SMS alert to program decision makers at the state and national TB program, shortening the new-case reporting period from months to seconds.
  9. 9. Abt Associates Results  The proportion of DR-TB patients enrolled for treatment based on GxAlert messages received from 35 GeneXpert facilities jumped to 85% in March, 2015 from only 20% enrolled in April 2014.  SMS or text message alerts are sent to TB Local Government supervisor, State program manager and National Program DR-TB enrollment officer upon GeneXpert confirmation of a MTB+ Rif+ case to speed treatment initiation.  Weekly reports of all new TB+ cases are both emailed and sent by SMS to local health officials to ensure better connection between diagnosis, enrollment and treatment.
  10. 10. Abt Associates Can we get better quality data, faster? Does it lead to NTP action? Do results get to patients? “We saw 3x the level of MDR we expected!” YES!
  11. 11. Abt Associates GxAlert Allows Data to Flow Across the Health System GH Kumo Kwali GH IDH Kano Zankli Lab NIMR Yaba SMS Email Computer App Other Systems: e-TB Manager DHIS2 • Connects diagnostic devices • Collects custom data • Sends alerts, notifications and reports to different level of care providers • Monitors and manages cartridge inventory • Records service, warranty, and maintenance events • Integrates with other health systems
  12. 12. Abt Associates Recap: Take Home Messages  GxAlert eliminates the need for human error in data entry, reduces the lag time, and helped pinpoint patients that should be place on care.  GxAlert strengthened surveillance of DR-TB, TB in children and TB in the HIV infected, speeding response and improving programmatic decision made for enrollment and placement of DR-TB patient on treatment.  The use of GxAlert SMS notification of GeneXpert testing suggests a scalable model for sustainability: Installation is done once and in-country.
  13. 13. QUESTIONS? Contact: Kehinde Jimoh Agbaiyero, Abt Associates OR Martha Benezet, Abt Associates