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 2015Q1 2016