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Chapter 49 : Cloud-Based Surveillance, Connectivity, and Distribution of the GeneXpert Analyzers for Diagnosis of Tuberculosis (TB) and Multiple-Drug-Resistant TB in South Africa

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Cloud-Based Surveillance, Connectivity, and Distribution of the GeneXpert Analyzers for Diagnosis of Tuberculosis (TB) and Multiple-Drug-Resistant TB in South Africa, Page 1 of 2

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Abstract:

Cloud computing is emerging as a new paradigm in health care information technology strategies and the growth of the industry. Despite reports emerging as early as the 1950s hinting at the potential of this approach, the strength of this is only now being realized in the health care sector. This is a simple principle of service-orientated architecture delivering a service around data rather than a product. The main enabling technology for cloud computing is virtualization. Virtualization is the ability to allow the system to operate independently of the hardware from the cloud via the Internet, so one can provide information to other users of hardware or software. In addition, resources can be shared within and between organizations to improve economies of scale. Data can be transferred in a computer network that is able to compartmentalize your needs.

Citation: Stevens W, Cunningham B, Cassim N, Gous N, Scott L. 2016. Cloud-Based Surveillance, Connectivity, and Distribution of the GeneXpert Analyzers for Diagnosis of Tuberculosis (TB) and Multiple-Drug-Resistant TB in South Africa, p 707-718. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch49
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Figures

Image of FIGURE 1
FIGURE 1

Current GeneXpert placements and clinic sites.

Citation: Stevens W, Cunningham B, Cassim N, Gous N, Scott L. 2016. Cloud-Based Surveillance, Connectivity, and Distribution of the GeneXpert Analyzers for Diagnosis of Tuberculosis (TB) and Multiple-Drug-Resistant TB in South Africa, p 707-718. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch49
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Image of FIGURE 2
FIGURE 2

Standard connections and protocol disparity. (Courtesy of Brad Cunningham.)

Citation: Stevens W, Cunningham B, Cassim N, Gous N, Scott L. 2016. Cloud-Based Surveillance, Connectivity, and Distribution of the GeneXpert Analyzers for Diagnosis of Tuberculosis (TB) and Multiple-Drug-Resistant TB in South Africa, p 707-718. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch49
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Image of FIGURE 3
FIGURE 3

Linkage-to-care using analyzer interface, SMS result distribution, and m-Health solution combined with training of nurses to trace contacts and administer MDR care.

Citation: Stevens W, Cunningham B, Cassim N, Gous N, Scott L. 2016. Cloud-Based Surveillance, Connectivity, and Distribution of the GeneXpert Analyzers for Diagnosis of Tuberculosis (TB) and Multiple-Drug-Resistant TB in South Africa, p 707-718. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch49
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Image of FIGURE 4
FIGURE 4

Geo-located devices. (Courtesy of Cepheid.)

Citation: Stevens W, Cunningham B, Cassim N, Gous N, Scott L. 2016. Cloud-Based Surveillance, Connectivity, and Distribution of the GeneXpert Analyzers for Diagnosis of Tuberculosis (TB) and Multiple-Drug-Resistant TB in South Africa, p 707-718. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch49
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FIGURE 5

2% errors per week.

Citation: Stevens W, Cunningham B, Cassim N, Gous N, Scott L. 2016. Cloud-Based Surveillance, Connectivity, and Distribution of the GeneXpert Analyzers for Diagnosis of Tuberculosis (TB) and Multiple-Drug-Resistant TB in South Africa, p 707-718. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch49
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FIGURE 6

LIS versus remote connectivity data.

Citation: Stevens W, Cunningham B, Cassim N, Gous N, Scott L. 2016. Cloud-Based Surveillance, Connectivity, and Distribution of the GeneXpert Analyzers for Diagnosis of Tuberculosis (TB) and Multiple-Drug-Resistant TB in South Africa, p 707-718. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch49
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FIGURE 7

Examples of audit indicators.

Citation: Stevens W, Cunningham B, Cassim N, Gous N, Scott L. 2016. Cloud-Based Surveillance, Connectivity, and Distribution of the GeneXpert Analyzers for Diagnosis of Tuberculosis (TB) and Multiple-Drug-Resistant TB in South Africa, p 707-718. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch49
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FIGURE 8

Journey from data to intelligence.

Citation: Stevens W, Cunningham B, Cassim N, Gous N, Scott L. 2016. Cloud-Based Surveillance, Connectivity, and Distribution of the GeneXpert Analyzers for Diagnosis of Tuberculosis (TB) and Multiple-Drug-Resistant TB in South Africa, p 707-718. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch49
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References

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1. Zhang JZ, Yao JY, Chen S, Levy D.2011. Facilitating biodefence research with mobile cloud computing. Int J Syst Serv-Oriented Eng 2:1831[CrossRef].
2. van den Hurk AF, Hall-Mendelin S, Johansen CA, Warrilow D, Ritchie SA.2012. Evolution of mosquito-based arbovirus surveillance systems in Australia. J Biomed Biotechnol 2012:325659[CrossRef].[PubMed]
3. Alemnji GA, Zeh C, Yao K, Fonjungo PN.2014. Strengthening national health laboratories in sub-Saharan Africa: a decade of remarkable progress. Trop Med Int Health 19:450458[CrossRef].[PubMed]
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6. Salka L, Kiechle F.2003. Connectivity for point-of-care glucose testing reduces error and increases compliance. Point Care 2:114118[CrossRef].
7. World Health Organization.2013. Global Tuberculosis Report. http://apps.who.int/iris/bitstream/10665/91355/1/9789241564656_eng.pdf.
8. Statistics South Africa. 2011. Statistical release: Census. Statistics South Africa, Pretoria, South Africa. http://www.statssa.gov.za/publications/P03014/P030142011.pdf.
9. South African National Department of Health.2010. The South African Antiretroviral Treatment Guidelines 2010. http://www.uj.ac.za/EN/CorporateServices/ioha/Documentation/Documents/ART%20Guideline.pdf.
10. UNAIDS.2013. Global Report: UNAIDS Report on the Global AIDS Epidemic. UNAIDS, Geneva, Switzerland. http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2013/gr2013/UNAIDS_Global_Report_2013_en.pdf.
11. World Health Organization.2013. Global Tuberculosis Report 2013. WHO, Geneva, Switzerland. http://apps.who.int/iris/bitstream/10665/91355/1/9789241564656_eng.pdf?ua=1/.
12. World Health Organization.2010. WHO endorses new rapid tuberculosis test. http://www.who.int/mediacentre/news/releases/2010/tb_test_20101208/en/index.html.
13. National Department of Health.2012. eHealth Strategy in South Africa (2012–2016). South African National Department of Health, Pretoria, SA.
14. World Health Organization.2010. Ebola Situation Report—11 February 2015. http://apps.who.int/ebola/en/ebola-situation-report/situation-reports/ebola-situation-report-11-february-2015.
15. Mehrfard H, Hamou-Lhadj A.2011. The impact of regulatory compliance on Agile software processes with a focus on the FDA guidelines for medical device software. Int J Inf Syst Model Des 2:6781[CrossRef].
16. Brown C, Arkell P, Rokadiya S.2015. Ebola virus disease: the ‘Black Swan’ in West Africa. Trop Doct 45:25[CrossRef].[PubMed]
17. National Health Laboratory Service (NHLS).2015. GeneXpert Remote Connectivity. http://www.nhls.ac.za/?page=cepheid_genexpert_interfacing&id=71.
18. Cepheid. 2013. Remote connectivity. In 5th Annual GLI Partners meeting, 17 April 2013, Les Pensières, Veyrie-du-Lac, France. http://www.stoptb.org/wg/gli/meetingarchive.asp.
19. Abbott.2007. Abbottlink Remote Diagnostics Delivers Integrated Care and Intelligent Insight. http://ekstern.infonet.regionsyddanmark.dk/files/Formularer/Upload/2013/06/AbbottLink%20Brochure.pdf.
20. Theron G, Peter J, Dheda K.2012. Characteristics of Xpert MTB/RIF-negative patients with pulmonary tuberculosis. Clin Infect Dis 55:472473, author reply 473474.
21. Blakemore R, Story E, Helb D, Kop J, Banada P, Owens MR, Chakravorty S, Jones M, Alland D.2010. Evaluation of the analytical performance of the Xpert MTB/RIF assay. J Clin Microbiol 48:24952501[CrossRef].[PubMed]
22. Hanrahan CF, Theron G, Bassett J, Dheda K, Scott L, Stevens W, Sanne I, Van Rie A.2014. Xpert MTB/RIF as a measure of sputum bacillary burden. Variation by HIV status and immunosuppression. Am J Respir Crit Care Med 189:14261434[CrossRef].[PubMed]
23. Terzian AS, Bodach SD, Wiewel EW, Sepkowitz K, Bernard MA, Braunstein SL, Shepard CW.2012. Novel use of surveillance data to detect HIV-infected persons with sustained high viral load and durable virologic suppression in New York City. PLoS One 7:e29679[CrossRef].[PubMed]
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Tables

Generic image for table
TABLE 1

Instrument management systems, middleware, and patient management systems

Citation: Stevens W, Cunningham B, Cassim N, Gous N, Scott L. 2016. Cloud-Based Surveillance, Connectivity, and Distribution of the GeneXpert Analyzers for Diagnosis of Tuberculosis (TB) and Multiple-Drug-Resistant TB in South Africa, p 707-718. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch49
Generic image for table
TABLE 2

Variable description of the National Priority Program LIS CDW and the Cepheid RM monitoring tools

Citation: Stevens W, Cunningham B, Cassim N, Gous N, Scott L. 2016. Cloud-Based Surveillance, Connectivity, and Distribution of the GeneXpert Analyzers for Diagnosis of Tuberculosis (TB) and Multiple-Drug-Resistant TB in South Africa, p 707-718. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch49
Generic image for table
TABLE 3

Example of data processing

Citation: Stevens W, Cunningham B, Cassim N, Gous N, Scott L. 2016. Cloud-Based Surveillance, Connectivity, and Distribution of the GeneXpert Analyzers for Diagnosis of Tuberculosis (TB) and Multiple-Drug-Resistant TB in South Africa, p 707-718. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch49

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