Abt Associates is working with Nigeria’s TB control agency to improve the speed and accuracy of TB testing results, enabling a more rapid, targeted TB response in the country.
Nigeria ranks third-worst among the world’s 22 high-burden tuberculosis countries in the world, according to the World Health Organization’s (WHO) 2015 global report on tuberculosis (TB). Nigeria has approximately half a million more cases of TB than previously believed, according to the report, with nearly 40 percent of cases undiagnosed. TB was the leading cause of death from infectious disease in 2014, surpassing HIV, according to WHO.
At the same time, Nigeria is taking steps to improve its transmission of TB testing results, which is expected to improve its TB treatment performance.
Abt Associates – as the implementer of USAID’s Health Finance and Governance (HFG) project – is helping Nigeria improve the speed and accuracy of TB test reporting. HFG, working with the National Tuberculosis and Leprosy Control Programme, is expanding use of software, developed party by Abt, which connects the country’s GeneXpert TB testing machines, reducing weeks or even months of waiting for results to just seconds.
Delivering Real-Time Data on TB in Nigeria
A GeneXpert machine with GxAlert software. Nigeria relies on the GeneXpert machine — an automated diagnostic test that can identify TB DNA and drug-resistant TB – to test for TB. More than 170 GeneXpert machines are used in facilities throughout Nigeria, with 130 additional machines to be installed before the end of 2016.
However, the machines are expensive and therefore positioned in central locations, far from many health facilities. Data can take weeks or even months to arrive for compilation and reporting at the country’s central health facilities. And data quality — especially from paper-based data tools — often is lacking and follow-up is time consuming.
HFG is supporting the National Tuberculosis and Leprosy Control Programme (NTBLCP) in implementing a mobile-based solution in 46 laboratories across the country. The GxAlert software, developed by Abt and SystemOne, works by connecting the GeneXpert to the internet, allowing results to be sent to an application and transferred into a central, secure database in real-time. This results in faster patient referrals into appropriate care.
The software was piloted in eight GeneXpert labs and eventually scaled nationally to all 46 GeneXpert sites across the country. Due to the program’s success, the NTBLCP expanded it approximately 250 more TB facilities across the country, an effort also supported by HFG.
The advent of the GxAlert application has had a tremendous impact on the TB response in Nigeria. By connecting all the rapid GeneXpert diagnostic machines to GxAlert, the NTBLCP and private health facilities are now able to:
- Report TB and HIV indicators in a real-time, automated process;
- Send targeted alerts by SMS or email to health system decision-makers;
- Deliver real-time disease surveillance data to the GxAlert database, linking to the electronic TB (eTB) Manager; and
- Prevent GeneXpert cartridge stock-outs and track usage for order accuracy.
Dr. Khaliru Al Hassan (center-left), then Minister of Health for Nigeria, launches an expansion of GxAlert software in March 2015. Former Minister of Health, Dr. Khaliru Al Hassan, said expanding use of the GxAlert system is an important step for Nigeria. “With technology, health service provision and delivery [have] been made easier and timely,” he said. The government’s ownership has been crucial for such a program to expand successfully.
Better Internet Connections, Faster Reliable Results
HFG is working on the scale-up of GxAlert with the installation of Smart Wi-Fi routers in all GeneXpert facilities in Nigeria. Recently, HFG Nigeria’s Acting Chief of Party, Dr. Gafar Alawode, and TB Senior Advisor, Kehinde Agbaiyero, accompanied representatives from the NTBLCP on a visit to the Zankli Hospital TB lab during the installation of these smart routers.
During the visit, the group discussed the benefits of GxAlert and the smart routers, and implications for TB epidemic control. These routers will provide faster, more reliable, more secure Internet connections, helping to overcome Internet challenges that impede the full effectiveness of the GxAlert system.
Read more about Abt’s work in tuberculosis: