GxAlert for Real-time Management and Strengthening of Remote GeneXpert Network in Bangladesh
GxAlert is a web-based open-source data connectivity application that includes a system for data management designed to work with any diagnostic device that can connect to the internet or a mobile network. Results from GeneXpert are automatically sent to the GxAlert server, which provides robust and clear documentation to connect existing monitoring and evaluation systems and eliminates the need for manual reporting and recording of any transcriptions or submission of results. The USAID-funded Challenge TB (CTB) Project has supported 39 GeneXpert sites in Bangladesh since March 2015. At the beginning of the CTB Project, many machines were down, there was a high percentage of errors and nonfunctional modules, cartridge stocks-out were frequent, and low uptake of the Xpert network was prevalent. There were no structured monitoring mechanisms to report the need for maintenance of GeneXpert machines or for logistics management, optimal utilization, understanding error codes, or timely enrollment of drug-resistant TB (DR-TB) patients to treatment. In addition, there was a lack of quality supervision and skilled human resources to monitor the machines across sites. However, many of the challenges could be resolved through the introduction of a real-time monitoring system called GxAlert. CTB introduced the system to connect GeneXpert machines and allow for remote monitoring and improvements in inventory management, maintenance, and utilization of the machines.