Calculation of TB patients' Drug Consumption using ENRS

1
Calculation of TB patients' Drug Consumption
using ENRS

• Amal Galal
• ME, Surveillance officer
• NTP Egypt

Dr. Samiha Baghdadi MO - EMRO WHO
2
Outlines

• What is ENRS
• What is the role of ENRS
• Historical background
• How ENRS can calculate the drug consumption of
  each TB patient.
• Applications on consumption using ENRS.
• At Central level
• At Provincial level
• At District level
• Challenges facing the nationwide expansion

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What is ENRS

• It is a standalone system using available soft
  wares (Excel/Access), with local copy of the
  database.
• It is the Electronic version of the main
  Registers in the TB recording reporting System,
  where Nominal data entry is done at TBMU level
  using Excel.
• Nominal data are then processed to produce the
  routine reports in the NTP, and calculate
  indicators using Excel and Access.
• Registers are linked using Access to produce
  patient profile and comprehensive data base

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What is the role of ENRS

• Improve quality of TB surveillance accuracy,
  completeness and timeliness of reporting and
  indicators calculation in NTP (high quality)
• Facilitate supervision and increase its
  efficiency
• Facilitate locating patients per their residency
  not only their place of diagnosis.
• Capacity building of human resources
• Improve planning and budgeting for TB drug
  management.

5
Historical background

• Electronic Nominal Recording reporting System
  (ENRS) in Egypt, was applied at the district
  level since 2006, after piloting in two
  provinces.
• After two years of implementation, the system was
  updated to integrate the four recommended
  registers (suspect, lab, district, contact)
  within the revised WHO recording reporting system
  aiming at upgrading data quality verification,
  plus data analysis and interpretation skills at
  the provincial district levels.
• More than 600 data entry persons in 157 TBMUs
  were trained on data entry, cleaning and ensuring
  the parameters of quality verification.
• A handy data entry user guides were developed to
  help in a simple way, supported by pictures and
  instructions for each file to be as a reference
  in data entry and to facilitate the quality of
  work.

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• Confidentiality is ensured through developing a
  TB_ID number for each patient, consisted of his
  serial no., province letter code, TBMU no. code
  and file code.
• A supervision plan is applied with a detailed
  checklist to review the hard and soft formats,
  also for measuring the quality parameters of
  recording and reporting.
• Lastly, in 2009 Egypt has the whole set of ENRS
  package, four files from 154 TBMUs in 28
  provinces were completed ( 45,000 records from
  suspects, 66,000 records from lab, 7300 records
  from district 14,000 records from contacts were
  recorded and available)

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How ENRS can calculate the drug consumption of
each TB patient

• The sheet is supported with equations to
  calculate the actual number of treatment days,
  based on the date treatment started and the date
  on which treatment ended.
• Based on the number of treatment days the system
  can calculate the actual consumption of the
  drugs.

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Applications on consumption using ENRS.
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Calculation of consumption at Central level_1

• The number of TB patients in 2009 and its
  breakdown by type outcome.

The actual number of treatment days by the same
breakdown
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Calculation of consumption at Central level_2

• The consumption of Isoniazid in 2009.

The consumption of Rifampin in 2009
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Calculation of consumption at Central level_3

• The consumption of Ethambutol in 2009.

The consumption of Pyrazinamide in 2009
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Calculation of consumption at Provincial level_1

• The number of TB patients in 2009 and its
  breakdown by type provinces.

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Calculation of consumption at Provincial level_2

• The number of treatment days in 2009 and its
  breakdown by type provinces.

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Calculation of consumption at Provincial level_3

• The consumption of Isoniazid in 2009 at
  provinces and the amount needed with buffer stock
  for the next year quantification.

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Calculation of consumption at Provincial level_5

• The consumption of Rifampin in 2009 at provinces
  and the amount needed with buffer stock for the
  next year quantification.

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Calculation of consumption at Provincial level_6

• The consumption of Ethambutol in 2009 at
  provinces and the amount needed with buffer stock
  for the next year quantification.

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Calculation of consumption at Provincial level_7

• The consumption of Pyrazinamide in 2009 at
  provinces and the amount needed with buffer stock
  for the next year quantification.

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Calculation of consumption at District level_1

• The number of TB patients in 2009 at Alexandria
  and its breakdown by districts

The number of treatment days at Alexandria and
its breakdown by districts
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Calculation of consumption at District level_2

• The consumption of Isoniazid in 2009, and the
  amount needed with buffer stock for the next year
  quantification.

The consumption of Rifampin 2009, and the amount
with buffer stock for the next year management
planning.
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Calculation of consumption at District level_3

• The consumption of Ethambutol in 2009, and the
  amount needed with buffer stock for the next year
  quantification.

The consumption of Pyrazinamide 2009, and the
amount with buffer stock for the next year
management planning
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Challenges facing nationwide expansion

• Expansion to other non NTP providers i.e. HIO,
  prisons, universities and others.
• Trained staff turn over which affect data quality
• Internet access not available in all TBMUs
  covered.
• Using national ID no. as a patient code to avoid
  duplication.

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Thank you