Harnessing Digital Application to Improve and Recording Reporting For TB Control In Bnagladesh

1. Harnessing Digital Application to Improve Recording and Reporting for TB Control
in Bangladesh: Roll-Out Experience and Opportunities
Authors: M G Kibria1, M A Taleb1, Z Islam1, S Bashar1, M Q Islam2
1SIAPS/MSH, Bangladesh; 2 National 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 that hinder epidemiological analysis, and a
lack of reliable data weakens surveillance and
performance. These factors ultimately increase the number
of drug-resistant and multi-drug-resistant (MDR)-TB
patients (proportion of TB cases with MDR-TB: new, 1.4%;
retreatment, 29%1). In 2011, the Systems for Improved
Access to Pharmaceuticals and Services (SIAPS) Program
assessed the NTP’s information management system.
After an options analysis, the NTP adopted the web-based
e-TB Manager (http://www.etbmanagerbd.org) to manage
TB patients and generate key reports and indicators.
Intervention: The NTP, in partnership with the World
Health Organization, piloted e-TB Manager at six sites in
November 2010. The NTP gradually rolled out e-TB
Manager to 255 sites, including all MDR sites in
Bangladesh. SIAPS trained 950 staff from the NTP and TB
partners and trained 13 master trainers to ensure the
smooth functioning of e-TB Manager. In August 2015, the
NTP notified district authorities that the use of e-TB
Manager was mandatory for recording and reporting
(TB10, TB11, and TB12) TB cases; 20 districts (with full
coverage of e-TB Manager in all sub-districts) were
identified as sentinel sites where the surveillance calendar
was introduced to monitor and improve data quality.
Conclusions:
The use of e-TB Manager, along with its sustainability, has
the potential to systematically organize critical surveillance
data and information needed for timely decision making.
With the 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.
Results:
• As of June 2016, 192,285 cases had been entered into e-
TB Manager, 62% of which were closed (n=119,809, Figure
1).
• A site performance analysis done in the first quarter of
2016 revealed that 83% of sites were maintaining high
performance, and the 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
improved significantly (132 cases in EW 1 vs 14 cases in
EW 18 were found to have data quality issues).
• NTP staff reported that e-TB Manager 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
Total number
of registered
cases=
192,285
“Category
A” denotes
high-
performing
sites and
“Category
D”
represents
low-
performing
sites.
80%
4% 5%
12%
83%
5% 5% 7%
0%
25%
50%
75%
100%
A B C D
Figure 2: e-TB Manager Site Performance (A/B/C/D) Analysis
Q4 2015
Q1 2016