Dr. Luis Gustavo Bastos Management Sciences for Health – Brazil
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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 15 th , 2011
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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 15 th , 2011. - PowerPoint PPT Presentation
Transcript of Dr. Luis Gustavo Bastos Management Sciences for Health – Brazil
Monitoring Drug Resistant Tuberculosis Treatment in Brazil through an Innovative
Web-based Information System
Dr. Luis Gustavo BastosManagement 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
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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
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
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
LABLABHealth Unit (HU)
Health Unit (HU)
Epidemiological surveillance / NTP Management Epidemiological surveillance / NTP Management
1st + 2nd LINE DRUG MANAGEMENT AT ALL LEVELS OF THE SUPPLY CHAIN
1st + 2nd LINE DRUG MANAGEMENT AT ALL LEVELS OF THE SUPPLY CHAIN
DATA ENTRY IN ONE SINGLE WEB-BASED
SYSTEM
DATA ENTRY IN ONE SINGLE WEB-BASED
SYSTEM
TB suspects
TB suspects TB casesTB cases DR-TB
suspects
DR-TB suspects
e-TBM can be used for TB + DR-TB Programmatic Management
DR-TB casesDR-TB cases
LAB COMMODITIES MANAGEMENT
LAB COMMODITIES MANAGEMENT
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)
MDR-TB Data Base / e-TB Manager– Hélio Fraga National TB Reference Center / Fiocruz/MoH - Brazil
Launched new MIS (Apr 2004)
New Training Program
New Guidelines
Capacity Building Activities
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
In productionIn pilot phaseIn discussion Only Drug Mngt platform
5,000 cases 471 cases
8,000 cases
16,000 cases
1,700 cases
An MIS implementation is an opportunity to strengthen TB/DRTB programs and motivate core staff:
Better understanding of guidelines + complementary roles (multi-disciplinary 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
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 …)
Upcoming developments
