User experience analysis of e-TB Manager, a nationwide electronic tuberculosis recording and reporting system in Ukraine

Abstract

Ukraine has successfully implemented e-TB Manager nationwide as its mandatory national tuberculosis registry after first introducing it in 2009. Our objective was to perform an end-of-programme evaluation after formal handover of the registry administration to Ukraine's Centre for Disease Control in 2015.We conducted a nationwide, cross-sectional, anonymous, 18-point user experience survey, and stratified the registry's transaction statistics to demonstrate usability.Contrary to initial implementation experience, older users (aged >50 years), often with limited or no computer proficiency prior to using the registry, had significantly better user experience scores for at least six of the 12 measures compared to younger users (aged 18–29 years). Using the registry for >3 years was associated with significantly higher scores for having capacity, adequacy of training received and satisfaction with the registry. Of the 5.9 million transactions over a 4-year period, nine out of 24 oblasts (regions) and Kiev city accounted for 62.5% of all transactions, and corresponded to 59% of Ukraine's tuberculosis burden. There were 437 unique active users in 486 rayons (districts) of Ukraine, demonstrating extensive reach.Our key findings complement the World Health Organization and European Respiratory Society's agenda for action on digital health to help implement the End TB Strategy.

Diagnostic performance and impact of routinely implemented Xpert® MTB/RIF assay in a setting of high incidence of drug-resistant TB in Odessa Oblast, Ukraine

“…Heteroresistance is known to occur more frequently in high TB incidence settings and in previously treated patients [25e27]; this is consistent with the study setting and composition of our cohort where >17% were retreatment cases undergoing multiple hospitalizations and incomplete treatment cycles. Importantly, the excellent overall agreement rates between molecular and phenotypic rifampicin sensitivity test results demonstrated in our study are consistent with improvements in laboratory practices, including implementation of liquid-culturebased systems (Bactec MGIT 960), regular external quality assessment rounds, and an electronic register introduced in the last decade [4,14].…”

“…Pulmonary specimens from presumptive and known TB cases were tested following national [10] and international guidelines using smear microscopy, culture on solid LowensteineJensen and liquid MGIT (mycobacteria growth indicator tube) media for TB detection, phenotypic first-line and second-line (where appropriate) drug susceptibility testing (DST) and, starting from 2013, Xpert MTB/RIF. The laboratory electronic databasedlinked to the National TB register eTB-Manager [14]dcontaining laboratory tests results and baseline demographic and epidemiological information was used as a source of clinical/epidemiological data for the study.…”

Digital health technologies to support access to medicines and pharmaceutical services in the achievement of sustainable development goals

“…18 Strong leadership and an official government mandate for the use of e-TB Manager, effective adult learning methodologies for computer novices, 19 and a steady five-year period enabled Ukraine to be the leader among all implementing countries, as demonstrated by its extensive nationwide diffusion of e-TB Manager by 2015, comparable to what Brazil first achieved between 2004 and 2008. 20 , 21 The World Health Organization’s (WHO) digital health for end tuberculosis strategy cited e-TB Manager as an example in contributing to quality patient-centered care and TB program management. 22…”

An e-registry for household contacts exposed to multidrug resistant TB in Mongolia

“…A variety of electronic TB registries and surveillance systems have been reported in recent years, including ETR.net (www.etrnet.info), ENRS (ccs.gov.eg/ntp/M_E_ENRS.htm), and e-TB manager (etbmanager.org/) (19,20).…”