Transcript Slide 1

Monitoring Drug Resistant Tuberculosis
Treatment in Brazil through an Innovative
Web-based Information System
Dr. Luis Gustavo Bastos
Management Sciences for Health – Brazil
ICIUM Conference – Antalya, Turkey – November 15th, 2011
A comprehensive web based tool conceived for strenghtening TB
programs by integrating case management, medicine control and
surveillance information into a single platform
Case notification and
management
Medicines supply and
stock control
Epidemiological
surveillance / Reports
Information
2
Overview of e-TB Manager: key interfaces and main features
 Easy online and real-time information
sharing + data consolidation among
different levels within one user –
friendly platform
e-TBM can be used for TB + DR-TB Programmatic Management
TB
suspects
DR-TB
suspects
TB cases
DR-TB cases
 Notification of lab results + sample
management (diagnosis: smear +
culture + DST (all techniques
including new LPAs) + HIV status –
data encoded by Lab or Health Unit
and validated at central level
DATA ENTRY IN ONE
SINGLE WEB-BASED
SYSTEM
LAB
1st + 2nd LINE DRUG
MANAGEMENT AT
ALL LEVELS OF THE
SUPPLY CHAIN
Health
Unit
(HU)
LAB
COMMODITIES
MANAGEMENT
Epidemiological surveillance / NTP Management
 Comprehensive medicine
management and control with an
automated patient based
quantification tool for ordering
process at all levels + demand and
forecasting tool
 Ensures patient data confidentiality
and database reliability through a
central level validation process
 Developed with open-source solutions
(no license required) that can be fully
customized to address specific
country needs
 Aligned with WHO recommendations
for DOTS and DR-TB programs,
including WHO standard forms for
reporting and recording
www.etbmanager.org
Divided into 4 modules - each one providing essential functionalities for
effective TB management
Note: Simulation Data for Demo
Note: Simulation Data for Demo
Note: Simulation Data for Demo
New developments
- Average monthly consumption and estimated stock on hand
Note: Simulation Data for Demo
Note: Simulation Data for Demo
Note: Simulation Data for Demo
E-TB Manager:
Data from Brazil
DR-TB Case Reporting
(Jan 2000 - Sep 2011)
New Guidelines
Capacity Building Activities
Launched new MIS (Apr 2004)
New Training Program
MDR-TB Data Base / e-TB Manager– Hélio Fraga National TB Reference Center / Fiocruz/MoH - Brazil
4,075 new MDR-TB cases (+ 734 retreatment)
Jan 2000 to Dec 2010
Previous TB Treatment
98% Pulmonary TB
Adverse reactions (45% of registered patients)
Comorbidities and Associated Factors
(33% of registered patients)
98% were tested for HIV with 8% positive results
Initial DR-TB Treatment Cohort Outcomes
(Jan 2000 - Dec 2009)
Patients non-DOT presented almost 3 times more treatment default than those with DOT
Lessons learned
Countries using e-TB Manager - 2011
16,000 cases
1,700 cases
8,000 cases
471 cases
5,000 cases
In production
In pilot phase
In discussion
Only Drug Mngt platform
An MIS implementation is an opportunity to strengthen
TB/DRTB programs and motivate core staff:
 Better understanding of guidelines + complementary roles (multidisciplinary team), contributing to better clinical care, work
“ambiance” and patient support
 Constructive forum for knowledge/experience sharing + motivating
transparent environment in comparing data and results among
states, treatment centres (e.g. contacts evaluation, curerates,
medicines management…)
 Increased awareness for accurate and updated information needs
at all levels for strategic decision taking
Reduction of delays: diagnosis (results release) => treatment
 Adv effect notification => adequate therapeutic conduct + PV
 TB/DR-TB descriptive epidemiology => better monitoring + action
taking
 Reduction of SLDs stock-outs/overstocks/wastage
 Better monitoring of:
 Irrational prescribing and lack of adherence
 Excess reporting
 Additional efforts to change and implement policy
Training is a crucial step for implementation
 Clear criteria for selection of appropriate participants
 Implementation planning as a core part of the training
 Demonstrated administrative/ managerial support
Upcoming developments
 Desktop version for countries with low internet coverage
 Link with GIS (Geographic Information Systems)
 Use of SMS (Text Messages) for rapid data exchange
 Enhanced laboratory module with WHO (all lab
commodities, including rapid diagnostic kits management,
equipment management, EQA, performance Indicators …)
Thank you for your attention!
Questions & Answers
Discussion
[email protected]