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.
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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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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 -