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.
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.
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.
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.
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.
Abt Associates
Why Connect GeneXperts?
Connected via GxAlert

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.
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.
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.
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.
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.
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.
QUESTIONS?
www.GxAlert.com
Contact:
Kehinde Jimoh Agbaiyero, Abt Associates
Kehinde_Agbaiyero@abtassoc.com
OR
Martha Benezet, Abt Associates
Martha_Benezet@abtassoc.com