Impact of GxAlert on the management of rifampicin-resistant tuberculosis patients, Port Moresby, Papua New Guinea

J. K. Banamu, Evelyn Lavu, K. Johnson, R. Moke, S Majumdar, K. C. Takarinda, Robert Commons

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Setting: GxAlert is an automatic electronic notification service that provides immediate Xpert® MTB/RIF testing results. It was implemented for the notification of patients with rifampicin resistant-tuberculosis (RR-TB) atPort Moresby General Hospital, Port Moresby, Papua New Guinea, in May 2015.

    Objective: To determine if there were differences in pre-treatment attrition, the time to treatment initiation and patient outcomes in the 12 months pre- and post-introduction of GxAlert for RR-TB patients.

    Design: This was a retrospective cohort study.

    Results: The median time from Xpert testing to treatment initiation decreased from 35 days [IQR 13–131] prior to GxAlert to 10 days [IQR 3–29] after GxAlert (P =0.001), with the cumulative proportion of patients initiating treatment within 30 days increasing from 25% (95%CI 17–37) to 54% (95%CI 44–64; P < 0.001) over these periods. However, our analysis of the time to treatment prior to the introduction of GxAlert suggests that a decrease had already occurred prior to implementation. There was no difference in interim clinical outcomes between the periods.

    Conclusion: Although a decrease in time to treatment initiation cannot be attributed to GxAlert, there was a significant improvement over the 2-year period, suggesting that considerable improvements have been made intimely RR-TB patient management in Port Moresby
    Original languageEnglish
    Pages (from-to)S19-S24
    Number of pages6
    JournalPublic Health Action
    Volume9
    Issue numberSupplement 1
    DOIs
    Publication statusPublished - 21 Sep 2019

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    Papua New Guinea
    Rifampin
    Tuberculosis
    Therapeutics
    General Hospitals
    Cohort Studies
    Retrospective Studies

    Cite this

    Banamu, J. K., Lavu, E., Johnson, K., Moke, R., Majumdar, S., Takarinda, K. C., & Commons, R. (2019). Impact of GxAlert on the management of rifampicin-resistant tuberculosis patients, Port Moresby, Papua New Guinea. Public Health Action, 9(Supplement 1), S19-S24. https://doi.org/10.5588/pha.18.0067
    Banamu, J. K. ; Lavu, Evelyn ; Johnson, K. ; Moke, R. ; Majumdar, S ; Takarinda, K. C. ; Commons, Robert. / Impact of GxAlert on the management of rifampicin-resistant tuberculosis patients, Port Moresby, Papua New Guinea. In: Public Health Action. 2019 ; Vol. 9, No. Supplement 1. pp. S19-S24.
    @article{07d56fa96d3b41e39a77e0b73c9d8300,
    title = "Impact of GxAlert on the management of rifampicin-resistant tuberculosis patients, Port Moresby, Papua New Guinea",
    abstract = "Setting: GxAlert is an automatic electronic notification service that provides immediate Xpert{\circledR} MTB/RIF testing results. It was implemented for the notification of patients with rifampicin resistant-tuberculosis (RR-TB) atPort Moresby General Hospital, Port Moresby, Papua New Guinea, in May 2015.Objective: To determine if there were differences in pre-treatment attrition, the time to treatment initiation and patient outcomes in the 12 months pre- and post-introduction of GxAlert for RR-TB patients.Design: This was a retrospective cohort study.Results: The median time from Xpert testing to treatment initiation decreased from 35 days [IQR 13–131] prior to GxAlert to 10 days [IQR 3–29] after GxAlert (P =0.001), with the cumulative proportion of patients initiating treatment within 30 days increasing from 25{\%} (95{\%}CI 17–37) to 54{\%} (95{\%}CI 44–64; P < 0.001) over these periods. However, our analysis of the time to treatment prior to the introduction of GxAlert suggests that a decrease had already occurred prior to implementation. There was no difference in interim clinical outcomes between the periods.Conclusion: Although a decrease in time to treatment initiation cannot be attributed to GxAlert, there was a significant improvement over the 2-year period, suggesting that considerable improvements have been made intimely RR-TB patient management in Port Moresby",
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    author = "Banamu, {J. K.} and Evelyn Lavu and K. Johnson and R. Moke and S Majumdar and Takarinda, {K. C.} and Robert Commons",
    year = "2019",
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    Banamu, JK, Lavu, E, Johnson, K, Moke, R, Majumdar, S, Takarinda, KC & Commons, R 2019, 'Impact of GxAlert on the management of rifampicin-resistant tuberculosis patients, Port Moresby, Papua New Guinea', Public Health Action, vol. 9, no. Supplement 1, pp. S19-S24. https://doi.org/10.5588/pha.18.0067

    Impact of GxAlert on the management of rifampicin-resistant tuberculosis patients, Port Moresby, Papua New Guinea. / Banamu, J. K.; Lavu, Evelyn; Johnson, K.; Moke, R.; Majumdar, S; Takarinda, K. C.; Commons, Robert.

    In: Public Health Action, Vol. 9, No. Supplement 1, 21.09.2019, p. S19-S24.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Impact of GxAlert on the management of rifampicin-resistant tuberculosis patients, Port Moresby, Papua New Guinea

    AU - Banamu, J. K.

    AU - Lavu, Evelyn

    AU - Johnson, K.

    AU - Moke, R.

    AU - Majumdar, S

    AU - Takarinda, K. C.

    AU - Commons, Robert

    PY - 2019/9/21

    Y1 - 2019/9/21

    N2 - Setting: GxAlert is an automatic electronic notification service that provides immediate Xpert® MTB/RIF testing results. It was implemented for the notification of patients with rifampicin resistant-tuberculosis (RR-TB) atPort Moresby General Hospital, Port Moresby, Papua New Guinea, in May 2015.Objective: To determine if there were differences in pre-treatment attrition, the time to treatment initiation and patient outcomes in the 12 months pre- and post-introduction of GxAlert for RR-TB patients.Design: This was a retrospective cohort study.Results: The median time from Xpert testing to treatment initiation decreased from 35 days [IQR 13–131] prior to GxAlert to 10 days [IQR 3–29] after GxAlert (P =0.001), with the cumulative proportion of patients initiating treatment within 30 days increasing from 25% (95%CI 17–37) to 54% (95%CI 44–64; P < 0.001) over these periods. However, our analysis of the time to treatment prior to the introduction of GxAlert suggests that a decrease had already occurred prior to implementation. There was no difference in interim clinical outcomes between the periods.Conclusion: Although a decrease in time to treatment initiation cannot be attributed to GxAlert, there was a significant improvement over the 2-year period, suggesting that considerable improvements have been made intimely RR-TB patient management in Port Moresby

    AB - Setting: GxAlert is an automatic electronic notification service that provides immediate Xpert® MTB/RIF testing results. It was implemented for the notification of patients with rifampicin resistant-tuberculosis (RR-TB) atPort Moresby General Hospital, Port Moresby, Papua New Guinea, in May 2015.Objective: To determine if there were differences in pre-treatment attrition, the time to treatment initiation and patient outcomes in the 12 months pre- and post-introduction of GxAlert for RR-TB patients.Design: This was a retrospective cohort study.Results: The median time from Xpert testing to treatment initiation decreased from 35 days [IQR 13–131] prior to GxAlert to 10 days [IQR 3–29] after GxAlert (P =0.001), with the cumulative proportion of patients initiating treatment within 30 days increasing from 25% (95%CI 17–37) to 54% (95%CI 44–64; P < 0.001) over these periods. However, our analysis of the time to treatment prior to the introduction of GxAlert suggests that a decrease had already occurred prior to implementation. There was no difference in interim clinical outcomes between the periods.Conclusion: Although a decrease in time to treatment initiation cannot be attributed to GxAlert, there was a significant improvement over the 2-year period, suggesting that considerable improvements have been made intimely RR-TB patient management in Port Moresby

    KW - GeneXpert

    KW - GxAlert

    KW - multidrug-resistant tuberculosis

    KW - tuberculosis treatment initiation

    U2 - 10.5588/pha.18.0067

    DO - 10.5588/pha.18.0067

    M3 - Article

    VL - 9

    SP - S19-S24

    JO - Public Health Action

    JF - Public Health Action

    SN - 2220-8372

    IS - Supplement 1

    ER -