The document discusses Bangladesh's adoption of an electronic tuberculosis (TB) management system called e-TB Manager (e-TBM) to improve TB recording and reporting. It notes that e-TBM has been rolled out to 255 sites across Bangladesh. As of June 2016, over 192,000 TB cases had been recorded in e-TBM, with 62% closed. Analysis found the percentage of low-performing reporting sites decreased from 12% to 7% after e-TBM introduction. Use of e-TBM has improved data quality and enabled timely reporting, which has potential to strengthen disease surveillance in Bangladesh.

1. Harnessing Digital Application to Improve Recording and
Reporting for TB Control in Bangladesh: Roll-Out
Experience and Opportunities
M G Kibria*1, M A Taleb1, Z Islam1, S Bashar1, M Q Islam2, Bangladesh
1SIAPS/MSH, Bangladesh
2National TB Control Program (NTP), Bangladesh
Background
For the National Tuberculosis Control Program (NTP)
of Bangladesh, accurate recording and up-to-date
reporting of tuberculosis (TB) case data is a major
challenge. The central manual data repository has
limited variables which hinder epidemiological
analysis, and lack of reliable data weakens surveillance
and performance, ultimately increasing the number of
drug-resistant and multi-drug-resistant (MDR)-TB
patients (proportion of TB cases with MDR-TB: new
1.4% and retreatment 29% 1). In 2011, SIAPS assessed
NTP’s information management system. After an
options analysis, NTP adopted the web-based e-TB
Manager (e-TBM-[http://www.etbmanagerbd.org]) to
manage TB patients and generate key reports and
indicators.
Intervention
Conclusion
Results and lessons learned
NTP, in partnership with the World Health
Organization, piloted e-TBM at 6 sites in November
2010. NTP gradually rolled out e-TBM to 255 sites
including all MDR sites in Bangladesh; SIAPS trained
950 staff from NTP and TB partners and developed 13
master trainers to ensure smooth functioning of e-
TBM. In August 2015, NTP notified district authorities
that use of e-TBM was mandatory for recording and
reporting (TB10, TB11, and TB12) TB cases; 20 districts
(with full coverage of e-TBM in all sub-districts) were
identified as sentinel sites where the surveillance
calendar was introduced to monitor and improve data
quality.
*Corresponding author’s email address: mkibria@msh.org
As of June 2016, total 192,285 cases were entered into
e-TBM; of which 62% were closed (n=119,809, Figure
1). A site performance analysis done in the first quarter
of 2016 revealed that 83% sites are maintaining high
performance and number of low performing sites
decreased from 12 % to 7% (Figure 2). Since the
inception of the surveillance calendar (Epidemiological
Week-EW), the accuracy of patient data has significantly
improved (132 cases in EW 1 vs 14 cases in EW 18
found which have data quality issues). NTP staff
reported that e-TBM enabled them to prepare timely
reports, easily analyze cases, and present at the
quarterly coordination meetings to strengthen the
disease surveillance system.
1 2015 Annual Report of National Tuberculosis Control Program of Bangladesh
Use of e-TBM, along with its sustainability, has the
potential to systematically organize critical
surveillance data and information needed for timely
decision making. With decentralization and high
visibility of TB patient data, stakeholders across the
health system can make real-time collaborations and
provide feedback to augment TB control in
Bangladesh.
Total number of
registered
cases= 192,285
(“Category A”
denotes high
performing site
and “Category
D” represents
low performing
site.