Bangladesh case study on how we implemented a connected diagnostics solution using GxAlert for infectious disease surveillance, TB program optimization and leveraging diagnostic data.
GxAlert Papua New Guinea Case Study 072518SystemOne
GxAlert's use in Papua New Guinea for disease surveillance and response. Initially used for Tuberculosis response, device management and second-line drug forecasting and stockage.
GxAlert for Real-time Management and Strengthening of Remote GeneXpert Networ...SystemOne
Real-time monitoring of GeneXpert machines can contribute to reduced error rates and shorter turnaround
times for module replacement and can improve the overall
maintenance of the machines. Emails and SMS alerts can speed
up treatment initiation. The NTP now gets SMS alerts and emails for DR-TB patient enrollment; stockout and error (>5%) rates; critical module errors; and monthly MDR reports to ensure better
connections among diagnosis, enrollment, and treatment.
Feasibility of an SMS intervention to deliver tuberculosis testing results in...SystemOne
Pre-treatment loss to follow-up is common for patients diagnosed with tuberculosis (TB) in high-burden countries. Delivering test results by SMS is increasingly being considered as a solution, but there is limited information about its feasibility as a public health tool in low resourced settings. It was found that reporting Xpert results via automated SMS is technically feasible and results in approximately half of patients receiving their test results immediately. Additional research should be done to address process inefficiencies in order to maximize impact of this technology and link its successful utilization to improved patient outcomes.
Accelerating the translation of medical research - 27 JuneInnovation Agency
Slides from the event focusing on translational research in Liverpool and North of England and why companies are establishing and growing operations in the region.
GxAlert Monitors and Reduces High Testing Error Rates in Nigeria's GeneXpert ...SystemOne
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
GxAlert Papua New Guinea Case Study 072518SystemOne
GxAlert's use in Papua New Guinea for disease surveillance and response. Initially used for Tuberculosis response, device management and second-line drug forecasting and stockage.
GxAlert for Real-time Management and Strengthening of Remote GeneXpert Networ...SystemOne
Real-time monitoring of GeneXpert machines can contribute to reduced error rates and shorter turnaround
times for module replacement and can improve the overall
maintenance of the machines. Emails and SMS alerts can speed
up treatment initiation. The NTP now gets SMS alerts and emails for DR-TB patient enrollment; stockout and error (>5%) rates; critical module errors; and monthly MDR reports to ensure better
connections among diagnosis, enrollment, and treatment.
Feasibility of an SMS intervention to deliver tuberculosis testing results in...SystemOne
Pre-treatment loss to follow-up is common for patients diagnosed with tuberculosis (TB) in high-burden countries. Delivering test results by SMS is increasingly being considered as a solution, but there is limited information about its feasibility as a public health tool in low resourced settings. It was found that reporting Xpert results via automated SMS is technically feasible and results in approximately half of patients receiving their test results immediately. Additional research should be done to address process inefficiencies in order to maximize impact of this technology and link its successful utilization to improved patient outcomes.
Accelerating the translation of medical research - 27 JuneInnovation Agency
Slides from the event focusing on translational research in Liverpool and North of England and why companies are establishing and growing operations in the region.
GxAlert Monitors and Reduces High Testing Error Rates in Nigeria's GeneXpert ...SystemOne
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
Ensuring you collect the best and most physiologically accurate data from your chronic telemetry experiments requires careful planning and experimental design. This webinar will give you an insight into the practical aspects of designing chronic animal experiments to set you on the best path for success. We will discuss the benefits of chronic studies, how to select the most appropriate sample size for your study, some basic tips and tricks for data acquisition and handling and finally how to ensure high animal welfare.
Learning Objectives:
What are the benefits of chronic over acute studies?
How to decide the best sample sizes and the length of experiments?
Basic tips for data acquisition and handling
Clinical trial data wants to be free: Lessons from the ImmPort Immunology Dat...Barry Smith
Presentation to the Clinical and Research Ethics Seminar, Clinical and Translational Science Center, Buffalo, January 21, 2014
https://immport.niaid.nih.gov/
http://youtu.be/booqxkpvJMg
My talk from the IBMS Congress 2019, outlining key challenges and advice, based on our experience, for people who want to implement pathogen genomics services.
Data Infrastructure for Real-time Analysis to provide Health InsightsQuahog Life Sciences
Illustrating how a well planned data infrastructure designed for real-time and continuous learning can have multiple advantages, facilitating better preventive strategies
Beating Bugs with Big Data: Harnessing HPC to Realize the Potential of Genomi...Tom Connor
Introducing the HPC challenges associated with developing a set of clinical microbial genomics services in the NHS in Wales. Demonstrating the potential of these technologies, and the impact it is already having for the patients of the Welsh NHS.
Regulatory Concerns When Running Virtual/Paperless Clinical TrialsTarget Health, Inc.
With drug and device manufacturers and the U.S. Food and Drug Administration (FDA) supplying much of the push, so-called paperless clinical trials are gaining momentum. In this eClinical Forum webinar, Dr. Jules Mitchel, President of Target Health, facilitated the discussion on the future landscape and regulatory concerns of paperless clinical trials and clinical trial design incorporating mobile tools.
Dr. Jules Mitchel, President of Target Health, delivered this presentation on the new FDA Guidance on the use of the electronic health record for clinical research at the North American eClinical Forum Autumn Meeting on October 2, 2018.
Who needs fast data? - Journal for Clinical Studies KCR
How “no news” during the life of a trial is bad news, and what data management (among other things) can do to help when ensuring access to fast data? Get to know this and more about smart e-solutions in the newest article of Kaia Koppel, Associate Director, Biometrics & Clinical Trial Data Execution Systems at KCR, in the recent issue of Journal for Clinical Studies (p.40-21).
Describes Indian Council of Medical Research, ICMR Institutes, importance of IT in health care, Health Information System and Mobile based Surveillance Quest using IT. For more information visit: http://www.transformhealth-it.org/
Ensuring you collect the best and most physiologically accurate data from your chronic telemetry experiments requires careful planning and experimental design. This webinar will give you an insight into the practical aspects of designing chronic animal experiments to set you on the best path for success. We will discuss the benefits of chronic studies, how to select the most appropriate sample size for your study, some basic tips and tricks for data acquisition and handling and finally how to ensure high animal welfare.
Learning Objectives:
What are the benefits of chronic over acute studies?
How to decide the best sample sizes and the length of experiments?
Basic tips for data acquisition and handling
Clinical trial data wants to be free: Lessons from the ImmPort Immunology Dat...Barry Smith
Presentation to the Clinical and Research Ethics Seminar, Clinical and Translational Science Center, Buffalo, January 21, 2014
https://immport.niaid.nih.gov/
http://youtu.be/booqxkpvJMg
My talk from the IBMS Congress 2019, outlining key challenges and advice, based on our experience, for people who want to implement pathogen genomics services.
Data Infrastructure for Real-time Analysis to provide Health InsightsQuahog Life Sciences
Illustrating how a well planned data infrastructure designed for real-time and continuous learning can have multiple advantages, facilitating better preventive strategies
Beating Bugs with Big Data: Harnessing HPC to Realize the Potential of Genomi...Tom Connor
Introducing the HPC challenges associated with developing a set of clinical microbial genomics services in the NHS in Wales. Demonstrating the potential of these technologies, and the impact it is already having for the patients of the Welsh NHS.
Regulatory Concerns When Running Virtual/Paperless Clinical TrialsTarget Health, Inc.
With drug and device manufacturers and the U.S. Food and Drug Administration (FDA) supplying much of the push, so-called paperless clinical trials are gaining momentum. In this eClinical Forum webinar, Dr. Jules Mitchel, President of Target Health, facilitated the discussion on the future landscape and regulatory concerns of paperless clinical trials and clinical trial design incorporating mobile tools.
Dr. Jules Mitchel, President of Target Health, delivered this presentation on the new FDA Guidance on the use of the electronic health record for clinical research at the North American eClinical Forum Autumn Meeting on October 2, 2018.
Who needs fast data? - Journal for Clinical Studies KCR
How “no news” during the life of a trial is bad news, and what data management (among other things) can do to help when ensuring access to fast data? Get to know this and more about smart e-solutions in the newest article of Kaia Koppel, Associate Director, Biometrics & Clinical Trial Data Execution Systems at KCR, in the recent issue of Journal for Clinical Studies (p.40-21).
Describes Indian Council of Medical Research, ICMR Institutes, importance of IT in health care, Health Information System and Mobile based Surveillance Quest using IT. For more information visit: http://www.transformhealth-it.org/
The Pistoia Alliance is examining the challenges of the Faster Safe Companion Diagnostics (CDx) by Aligning Discovery & Clinical Data in the Regulatory Domain.
The slides discuss whether the data standards used in the research environment be aligned better with the data standards used in the regulated environment? If so, the time and cost of the development of NGS-based CDx could be reduced.
10 Ways in which Technology is Driving Better Efficiency in Clinical TrialsInsights10
New technological innovations are improving the efficiency and productivity of clinical trials using novel outcomes, increasing patient engagement, and reducing patient burden. To get a report in detail, contact us at - info@insights10.com
Patients should be able to trust their doctors blindly. However, for most of the masses getting a second opinion is has become a necessity. A doctor, albeit a human, should be able to guarantee their diagnoses of the patient. With the current advancements of technology, it is shocking that technology is not being utilized to give this guarantee. Technology is present and ever evolving to remove human error.
Thus, with the aim of using new technologies such as deep learning and neural networks, our team is developing a way to assist doctors in their diagnoses by analysing chest x-rays. Chest x-rays show a number of diseases including heart and lung issues, fluid vessels and airways. Our software based solution, will be able to analyse chest x-rays and mark any abnormalities found thereby pointing towards the correct diagnoses and improving a doctors’ efficiency in diagnoses.
Oscar Rodríguez-El impacto de las ciencias ómicas en la medicina, la nutrició...Fundación Ramón Areces
El 29 de marzo de 2016 celebramos un Simposio Internacional sobre el 'Impacto de las ciencias ómicas en la medicina, nutrición y biotecnología'. Organizado por la Fundación Ramón Areces en colaboración con la Real Academia Nacional de Medicina y BioEuroLatina, abordó cómo un mejor conocimiento del genoma humano está permitiendo notables avances hacia una medicina de precisión.
Similar to Gx alert casestudy bangladesh_062618 (20)
The Role of Connected Diagnostics in Strengthening Regional, National and Con...SystemOne
Although numerous disease intelligence and surveillance systems exist, they are plagued with inaccurate or untimely data. We contend, furthermore, that it was this lack of data quality – and not
the lack of surveillance systems or networks – that prevented the global community from acting earlier in response to the Ebola outbreak in 2014–2016. The new field of ‘connected diagnostics’ is one solution to this concern, as it automates data collection directly from the diagnostic instruments to multiple levels of stakeholders for real-time decision-making and policy response.
This article details how the intervention of ‘connected diagnostics’ could solve the primary underlying failure in existing surveillance systems – the lack of accurate and timely data – to enable
difficult political decisions earlier. The use of connectivity solutions can enable critical health and operational data to empower the Africa CDC, regional hubs, and each country with a consistent
and automated data feed while still maintaining country privacy and controls.
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Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
1. BACKGROUND
Bangladesh is one of the most densely populated countries in the
world, with a population of 163 million people (World Bank, 2016). It is
also one of the world’s 30 high TB burden countries with an estimated
incidence of 360,000 cases in 2017 (WHO Global TB Report).
To help address the high burden of disease, the GeneXpert MTB/RIF
was introduced into Bangladesh in 2012 to diagnose TB and MDR-TB.
THE CHALLENGE
In Bangladesh, GeneXpert instruments are operated in challenging
laboratory environments due to temperature, dust, variable laboratory
infrastructure and lack of human resources. At the start of the
GeneXpert program, numerous issues hampered effective use of these
diagnostic machines. With no maintenance capabilities, no monitoring,
no calibration expertise and no way to know which machines were
working at which diagnostic testing facilities, the program ended up
having a high number of non-functional instruments or instruments
that were not effectively being used.“Of 39 GeneXpert machines,
9 machines were not functioning at the beginning,”said Sarder
Tanzir Hossain, Senior Technical Advisor TB Laboratory, Challenge TB
Bangladesh Project, Management Sciences for Health (MSH).
Further challenges included:
• Monthly reports from GeneXpert machines were still being
reported on paper, requiring active data collection.
• 25% of instruments were non-functional at any given time.
• The module failure rate was 10.4%.
• The system was plagued by low instrument utilization rates.
• Error rates were collected but the lack of error code data made
it difficult to determine the sources of errors and rectify them.
• As in other countries, test results were not being sent back to
referring clinicians, resulting in low linkage to care for patients
diagnosed with TB and MDR-TB.
• Instrument calibration and maintenance schedules were
difficult to track.
Country Bangladesh
Instruments 39
Diseases TB
Assays GeneXpert MTB/RIF
Funding
Partner
USAID
Implementing
Partners
KNCV, MSH and IRD
Implementing
Project
Challenge TB
Local Heroes Dr. Pronab Kumar Modak,
DPM Training and Lab
Focal Person, NTP, DGHS,
MOH FW.
Ebne Sayeed Md.
Imtiaz Senior Technical
Advisor, mHealth,
Management Sciences
for Health.
Sarder Tanzir Hossain,
Senior Technical
Advisor - TB Laboratory,
Management Sciences
for Health.
FROM DATA TO IMPACT
Implementation Summary
CASE STUDY: SWAZILAND
FROM DATA TO IMPACT
Implementation summary
Country Swaziland
Laboratories 28
Diseases MTB, MDR TB
Devices
Assays
GeneXpert, MTB and
MDR TB
Funding
Partner
Global Fund
Local Heroes: Lead:
Themba Dlamini,
Program Manager, NTP
Dr. Welile Sikhondze,
Technical Advisor and
Research Coordinator,
NTP
Sindisiwe Dlamini,
Chief Laboratory
Technologist, SHLS
Team Members:
Doctor Busizwe
Sibandze
Drug Resistance Survey
Laboratory Manager,
NTP
Tumiso Matumba
Information Technology,
National ICT Officer, NTP
Thando Mabuza,
Assistant ICT Officer, NTP
Derrick Khumalo
Principal Technologist
SHLS/NTP Laboratory
Coordinator
Sylvester Moyo
Laboratory Information
System Manager, CHAI
Tufuma Zanamwe
Laboratory Information
System Manager, ICAP
Pinky Kubheka
Regional Laboratory
Advisor, ICAP
Justice Makuni
Software Developer,
HMIS
THE CHALLENGE:
MODERN DIAGNOSTICS AND TRAINED STAFF HAMPERED BY DISTANCE AND
COMMUNICATION ISSUES
The Swaziland NTP understood that despite having a fleet of new GeneXpert
diagnostic devices and a skilled staff, they would not realize the full potential of
these new devices without a robust device management platform. To maximize
the use of GeneXperts, and eventually other diagnostics, the NTP needed to:
• understand utilization;
• figure out which errors were happening and why;
• implement rapid response to diagnoses;
• deploy targeted training resources efficiently; and,
• manage a fleet of expensive devices over the long term.
A robust device management connectivity platform could help realize the new
technology’s promise. In addition to the immediate issues of improving time to
treatment and system optimization, the Swaziland NTP wanted to take advantage
of platform to:
Manage inventory:
• Optimizing procurement and utilization
• Reducing wastage
Manage devices:
• Remotely, identify and fix device errors rapidly
• Maintain devices and keep warranties up to date, and reduce
costs over time
Collect and analyze data, to:
• understand disease trends and
patterns
• use custom fields to optimize
laboratory processes and
patient care
• ensure data privacy and control
• automate time-consuming
reports
Doctor Busizwe Sibandze installs
GxAlert at the Raleigh Fitkin Memorial
Hospital laboratory with supervision
from Tumiso Matumba and
SystemOne’s Max Strong.
BANGLADESH: A CASE STUDY
Implementation of GxAlert by
Bangladeshi team
2. THE SOLUTION
Ebne Sayeed Md. Imtiaz (MSH), Sarder Tanzir Hossain (MSH) and Dr Pronab Kumar Modak from the Bangladesh National
Tuberculosis Program (NTP) performed a landscape assessment and worked with the USAID-funded Challenge TB Program
to select the most appropriate connectivity solution. Challenge TB funded SystemOne to connect its diagnostic connectivity
solution GxAlert to 39 GeneXpert instruments (which were procured by USAID) between November 2016 and February 2018.
GxAlert enabled a solution to address the following gaps:
• Device management, monitoring and reporting
• Calibration, maintenance and procurement planning
• Lab technologist capacity, availability and training
• Real-time results notification to respective stakeholders
• Acceleration of time to treatment for patients.
During the 6 months after the initial GxAlert training, the Bangladesh NTP trained a core group of staff who immediately
began working with the data generated from GxAlert to identify rapid ways to improve the GeneXpert device management,
set appropriate alerts and ensure that TB results moved quickly from the testing devices to the right clinicians.
SUCCESSES AND MOVING FORWARD
@SystemOneCo SystemOne.id
CASE STUDY: SWAZILAND
FROM DATA TO IMPACT
Implementation summary
Country Swaziland
Laboratories 28
Diseases MTB, MDR TB
Devices
Assays
GeneXpert, MTB and
MDR TB
Funding
Partner
Global Fund
Local Heroes: Lead:
Themba Dlamini,
Program Manager, NTP
Dr. Welile Sikhondze,
Technical Advisor and
Research Coordinator,
NTP
Sindisiwe Dlamini,
Chief Laboratory
Technologist, SHLS
Team Members:
Doctor Busizwe
Sibandze
Drug Resistance Survey
Laboratory Manager,
NTP
Tumiso Matumba
Information Technology,
National ICT Officer, NTP
Thando Mabuza,
Assistant ICT Officer, NTP
Derrick Khumalo
Principal Technologist
SHLS/NTP Laboratory
Coordinator
Sylvester Moyo
Laboratory Information
System Manager, CHAI
Tufuma Zanamwe
Laboratory Information
System Manager, ICAP
Pinky Kubheka
Regional Laboratory
Advisor, ICAP
Justice Makuni
Software Developer,
HMIS
THE CHALLENGE:
MODERN DIAGNOSTICS AND TRAINED STAFF HAMPERED BY DISTANCE AND
COMMUNICATION ISSUES
The Swaziland NTP understood that despite having a fleet of new GeneXpert
diagnostic devices and a skilled staff, they would not realize the full potential of
these new devices without a robust device management platform. To maximize
the use of GeneXperts, and eventually other diagnostics, the NTP needed to:
• understand utilization;
• figure out which errors were happening and why;
• implement rapid response to diagnoses;
• deploy targeted training resources efficiently; and,
• manage a fleet of expensive devices over the long term.
A robust device management connectivity platform could help realize the new
technology’s promise. In addition to the immediate issues of improving time to
treatment and system optimization, the Swaziland NTP wanted to take advantage
of platform to:
Manage inventory:
• Optimizing procurement and utilization
• Reducing wastage
Manage devices:
• Remotely, identify and fix device errors rapidly
• Maintain devices and keep warranties up to date, and reduce
costs over time
Collect and analyze data, to:
• understand disease trends and
patterns
• use custom fields to optimize
laboratory processes and
patient care
• ensure data privacy and control
• automate time-consuming
reports
Doctor Busizwe Sibandze installs
GxAlert at the Raleigh Fitkin Memorial
Hospital laboratory with supervision
from Tumiso Matumba and
SystemOne’s Max Strong.
Bangladesh Deep Dive training
As of June 2018, a total of 189,484 GeneXpert test results have been uploaded onto
GxAlert. Due to GxAlert’s real-time monitoring and immediate feedback capabilities,
the data these tests generated led the NTP to take action and yield the following
improvements:
• National error rates have decreased by 46%; from 6.09% in 2015 to 2.81%
in 2017.
• The most common test errors and sources, by testing site and user, have
been identified. The NTP learned that specimen processing errors were
occurring frequently, which prompted retraining efforts for staff.
• Being able to manage cartridge stock, including expiry dates for cartridges
on GxAlert, has resulted in the NTP being proud to report that stock-outs
have been eliminated.
• Cepheid’s local distributor can remotely monitor the module status
(failures) and take preventive actions that have led to a significant drop in
module replacement time, from 5-14 months in 2015 to only 2 weeks in
2017.
• From experiencing numerous machine and module failures, the program
now has 100% machines operational with 90% of modules operational at any
given time.
“The SystemOne Data Deep Dive helped us uncover extremely useful data, which
enabled us to improve our referral system and see which mutations were prevalent
in which regions,”said Sarder Tanzir Hossain.“This alone has helped us ensure we can
distribute the right treatment to the right locations.”
The NTP intends a national expansion from 200 to 615 machines. As with many
countries, NTP staff recognize that eventually the system would benefit from a full-
time position to monitor the network and follow up on actionable items, whether
these are offline machines, broken modules, or ensuring that referring clinicians are
initiating treatment.
BANGLADESH: A CASE STUDY