Determination of the level of congruence between the geneXpert laboratory management information system and the TIBU surveillance system for Kiambu County TB patients, 2014 ‐2016

Abstract

Background: The introduction of Gene Xpert® MTB/RIF assay (“genexpert”; Cepheid, Sunnyvale, USA) (GeneXpert) in the diagnosis of Tb has been a practice changer not only in the speed of diagnosis but also in the early and prompt identification of rifampicin resistance. Data generated from the use of geneXpert is managed in the GeneXpert Laboratory Information Management System (GX‐LIMS) as well as the Tuberculosis Information from Basic Units (TIBU). There is minimal knowledge on the interplay of the two platforms in the country.

Objective: To determine of the level of congruence between the GeneXpert laboratory management information system and the TIBU surveillance system for Kiambu county TB patients, 2014 ‐2016.

Design: An analytic comparative cross‐sectional study.

Setting: Kiambu County, Kenya.

Population: All patients notified into TIBU and entered in GX‐LIMS within Kiambu County, 2014 ‐2016.

Results: In the study period, there was a gradual increase in the number of GeneXpert tests done in Kiambu County. Patients tested in GX‐LIMS were 171(2%), 1610(26%) and 6186 (78%) in 2014, 2015 and 2016 respectively. Of these, 60(4%), 209(16%) and 1272(83%) were notified into TIBU in the respective years. In the study period, 29 patients were Rifampicin resistant as per GX‐LIMS, with 13 being notified into TIBU for care.

Conclusion: Our study showed that there is poor congruence between GX‐LIMS and TIBU in Kiambu County. There is need for the development of unique patient identifiers that can be used to track and follow up patients from the point of testing in GX‐LIMS to notification into TIBU for care. This will limit the number of patients lost to follow‐up.