How Connected Diagnostics Help the Fight Against TB in Papua New Guinea
Interview with Jennifer Kopania Banamu, Scientific Officer in charge of TB, Central Public Health Lab, Papua New Guinea.
by Nancy Brown, Director of Business Development, SystemOne
Author’s Note: I met Jennifer Kopania Banamu last fall at the Union World Conference on Lung Health in Hyderabad, India. She walked up to the SystemOne booth with a warm, wide smile and said “I love GxAlert! It has changed the way we work.” Jennifer is based in Port Moresby, the capital city of Papua New Guinea, a country of immense cultural and ecological diversity. There are at least 851 languages spoken in PNG, the terrain is mountainous and includes active volcanoes as well as sprawling rainforests, and the weather is often hot and very wet. Internet and electricity can be unreliable, making timely and coordinated healthcare a unique challenge for the government and local healthcare workers. The interview that follows has been edited and condensed for clarity.
How many labs do you supervise and what are your primary responsibilities?
We have 113 TB microscopy sites in the country which we supervise. The labs are located all across the country, which is mountainous and thickly rain-forested. Travel for patients and health workers is difficult at times and the internet signal is not always good.
How long have you been using GxAlert?
Since 2015. We currently have 48 GeneXpert devices connected.
How has GxAlert changed the way you manage your program? Can you give an example?
GxAlert improves the turn-around-time from lab to the clinical team. As soon as samples are tested and results are ready, we receive instant notifications from the lab. The timely transfer of data means we now have the ability to immediately implement our national MDR-TB protocol which involves notifying the national team of Rifampicin (RIF) positive results and also emailing those results to the specific districts affected. The spread of disease is slowed and lives are saved.
You were the lead researcher in a recent publication “Impact of GxAlert on the management of rifampicin-resistant tuberculosis patients, Port Moresby, Papua New Guinea.” What were your key findings?
We wanted to know if GxAlert was helping to reduce the loss to follow up that often happens when there is too much time between when a TB test is taken and when results are received by the clinician and patient. And we found that yes, GxAlert does help clinicians provide patients with timely and effective care, something that could not be more important when treating TB.
What are some of the challenges you face working with technology in Papua New Guinea?
We face a lot of challenges. The workforce is computer illiterate and the local internet is not reliable. This limits what we can do with any system. Also, we struggle to find funding to keep our systems running, including finding a budget for the data and dongles. We also cannot afford to maintain our warranty with Cepheid. We replace modules as they fail.
Can you think of ways to improve the GxAlert software?
Yes, by directly linking test results to treatment. And so we are looking for funding now to upgrade from GxAlert to Aspect and look forward to using Aspect Reporter.
Would you recommend GxAlert to others?
Yes. The software helps us identify the number of RIF indeterminates, something that wasn’t easy to accomplish previously. We can now put patients on a drug susceptible regime sooner. There are many features to the software but we’d recommend not to wait for formal training, but just go ahead and start using it. You will learn what is most helpful for yourselves.
Any final comments?
Because of GxAlert, we can have accurate national-level results and we can communicate effectively with the field through email notifications. This is very helpful to our program, which seeks to provide timely, effective treatment to patients suffering from TB.