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Office of HIV/AIDS & Tuberculosis
History of Use of GxAlert
Background on Nigeria
• 4th in terms of global TB burden
• Highest TB burden in Africa
• TB incidence: 322/100,000 population
• TB treatment coverage - CDR is 17%
• National HIV prevalence - 3.4%
• TB/HIV co-infection 17%
• Prevalence of MDR-TB among new
cases is 2.9%
• Service delivery points:
– >5,940 DOTS centers
– >1,925 AFB centers
– 377 GeneXpert sites
– 8 TB culture labs
What are we connecting and why?
Area (LGA) Sup.
GX sites It takes at
the data to
• Real time feedback to patients, clinicians, and
program staff on test outcomes
• Real time notification to state program on MTB/RIF
resistance cases diagnosed
• Early warning system for:
– Non-functioning machines
– Cartridge stock level
– Warranty expiration
– QA issues
• Timely reporting of appropriate indicators
• Site-level visibility into Xpert site functionality
• 298 out of 377 sites installed and ongoing
• Great collaboration between donors
– USAID-funded dashboard development and roll-out to 200 sites
initially and will pick up where GF leaves off
– GF funding roll out to 100 sites
• Expanded original concept to address TB/HIV data needs
• Buy-in of National TB Control Programme and partners
Who actually has access to the information?
Site connectivity information and performance
How Information from the Dashboard is Managed
• NTP IT staff monitors
dashboard and updates NTP
Lab Unit of maintenance-
related issues (not sure how
often) and IPs are informed
once a quarter to resolve.
• Testing data from GxAlert is
not used for reporting
• Inventory module not used for
• Expand relevant access to all
key stakeholders at different
– Implementing partners who
support the sites need access
to timely information to
respond to issues as they
• Use GxAlert data real time and
• Ensure proper use of the
inventory module and data for
Major Organizational Issues Affecting Project Success
• Issue: NTP’s reluctance to expand access to the
dashboard to include other key stakeholders who are
critical to ensuring successful operations
• Action Taken (or to be taken): Ongoing dialogue with
NTP to make them understand why it is critical to ensure
that access is granted to every category of end user of the
information available on the dashboard, as well as the
need to use this data for decision making.
• Lessons Learned: The need to define user agreements
from the onset of such a project is critical to success.
Major Operational Issues Affecting Project Success
• Issue: Gap in support to ensure optimal understanding and
utilization of the full capabilities of this tool.
• Action Taken (or to be taken): Development of a user guide
for facility staff as well as setting up a support structure to
quickly address issues as they come up.
• Lessons Learned: Availability of timely and accurate technical
support is critical to the success of using IT solutions especially
in challenging environments like Nigeria.
• Sustain connectivity
• Figure out Unique Patient Identifier to help
integration across platforms
• Integrate with other systems (e-TB, DHIS, etc.)
• Provide timely maintenance support to sites
• Connect system with other diagnostic tools