DATA ANALYTICS

-By Fustina Orazu

 CAN
TELEPATHOLOGY
REDUCE THE RATE OF
TUBERCULOSIS
INCIDENCES IN NIGERIA IN A YEAR
 Ø INTRODUCTION
Ø BRIEF SUMMARY OF HEALTH PROBLEM
Ø INTERVENTION
Ø DATA ANALYSIS

Agenda Ø
Ø
Ø
EXISTING SOLUTION
ACTIONABLE INSIGHT
SOLUTION
Ø IMPLEMENTATION
Ø LIMITATIONS
Ø SUMMARY
Ø REFERENCE
Ø
Ø
Ø
 Introduction
• The Country: Nigeria
• The Population: 18 and above
• The Health Problem: Tuberculosis
 TUBERCULOSIS (TB) Skin tests, blood tests, x-rays,
and other tests can tell if you
have TB. If not treated
Tuberculosis (TB) is a
properly, TB can be deadly.
disease caused by bacteria
You can usually cure active TB
called Mycobacterium
by taking several medicines
tuberculosis. The bacteria
for a long period of time.
usually attack the lungs, but
they can also damage other
parts of the body.

Symptoms of TB in the lungs may

include a bad cough that lasts 3 weeks
or longer ,Weight loss, Loss of
appetite, Coughing up blood or
mucus, Weakness or fatigue, Fever, TB spreads through the air when a
Night sweats person with TB of the lungs or
throat coughs, sneezes, or talks

You are more likely to get TB if you

have a weak immune system(HIV)
 There are two TB-related conditions exist: Latent TB infection (LTBI) and TB disease.
A positive TB test result means only that TB bacteria has been detected. It does not indicate whether the person has
active TB or a latent infection. This requires additional testing. TB disease can be diagnosed by medical history,
physical examination, chest X-ray, and other lab tests.
Top 10 cause of Death in low income countries

Tuberculosis and lower

respiratory infections are in
the top 5 communicable
diseases or conditions in low
income countries

Over 95% of TB deaths occur

in low- and middle-income
countries. Six countries
account for 60% of the total,
with India leading the count,
followed by Indonesia,
China, Nigeria, Pakistan and
South Africa.[1]
 Factors that contribute to the Spread of
Tuberculosis in Nigeria

Costs of Poor living

Accessing Tobacco use
conditions
Healthcare

Poor quality of
Inability to afford Alcohol Abuse
Healthcare Low Immunity
healthcare
Services

Low rate of Fear of

Healthcare Uunawareness Stigmatization
professional
How does the Cost of Diagnoses and Treatment influences
Tuberculousis Incidence?
PYTHON R STATISCAL SOFTWARE EXCEL
Microsoft Power BI, a data analytics and
visualization software

Ø Cost of Treating
Tuberculosis in
Nigeria and in the
United State

Ø Cost of Diagnosising
Tberculosis in Nigeria
and in the United
States
From the above Dataset, i concluded the following happened between 2015-2017
• The United States spent a lot of money in ensuring that the rate of Tuberculosis
incidence was reduced between 2105-2017 but Nigeria spent a lot of money but still
the TB rate is on the increased
• Nigeria spends more than USA in diagnosing TB but yet end up with more fatalities than
USA
• Most importantly and really shocking discovery is that Diagnosing and Treating TB is not
done properly in Nigeria because we can see from the graph that the DR-TB incidence
is so high, higher than the previous years combined(more like no one was treated!)
Technology that has attempted to solve the
[1]
Tuberculouis incidence

[2]

Rapidly diagnoses TB disease and drug resistance TB

The test simultaneously detects Mycobacterium tuberculosis complex

(MTBC) in less than 2 hours. However, it is not used in Nigeria
anymore.
Subpopulation that contribute to the Problem
The Minister of Health Representative, Mr Felix Ogenyi stated
Low Income or Poverty that “In Nigeria, TB, is a disease that affects mostly the poor
are contributors and low socio-economic population and it usually leaves the
patient and households with devastating financial loss. A survey
was conducted by the office of Nigerian Ministry Of Health
between 2017 -2018 to confirm this and to evaluate its impact.
The results of this survey have revealed that nearly 60% of
Some other overlooked solution tuberculosis patients live below the poverty line” [3]…
are:
• Healthier BMI because it will
increase immunity to TB
Bacteria
• Exercise and Right diet will
also
• Controlled Alcohol
consumption
 • I discovered that diagnoses and Treatment can
Findings determine the rate of Tuberculousis incidences in a
country through my analysis of the above data.
• The Annual growth rate of TB incidence is Greater in
low income countries than in Higher income
countries becuase the rate of incidence from 2000-
2017 in low income countries increased by 5.7% with
a Confidence interval of 4.6-6.9 and in Higher
income countries it is at 2.4% with Confidence
Interval of 1.1-3.5
• The mean average spent by a low income country is
$3152.5 but a Higher income country mean average
is $1677(i use 95%CI for all)
My Proposed Solution Is

Telehealth
Telepathology
 WHAT IS
WHAT IS PATHOLOGY TELEPATHOLOGY
Pathology is a branch of medical
Telepathology is the practice
science that involves the study
of pathology at a distance. It
and diagnosis of disease through
uses telecommunications
the examination of surgically
technology to facilitate the
removed organs, tissues (biopsy
transfer of image-rich
samples), bodily fluids, and in
pathology data between
some cases the whole body
distant locations for the
(autopsy).
purposes of diagnosis,
education, and research.[4]
 Telepathology

There are 105pathologistic in Nigeria and there are 200million people in Nigeria . This means One
pathologist to 500,000, this is obviously very alarming.
Diagnosing TB in Nigeria takes about 4-6weeks but using Telepathology, it can be done under 1hr.
We have also seen from the analysis that there is little or no investment in the treatment of TB and
that is why the rate of DR-TB patients are on the increase and this will cause more havoc.
A studies was done in Botswana with Teleopathology and now Botswana is one of the countries that
have low rate of TB in Africa. In Botswana , all person aged 15 and above are screened for TB.
Testing has drastically reduced TB rate. The Pandemic of TB is now an Endemic(mostly prevalent
amongst people with HIV and they are monitored meticulously)
 Technical requirement

Telepathology systems must be good enough to handle slides quality, focal planes, and specimen types/sizes, so adequate
Internet connectivity(a wireless broadband will be great) and a stable power source are crucial(a power generator or UPS).

• Realtime Telepathology Imaging System™ (RTIS) for communicating diagnostic quality images between pathologists
• PathScan Enabler for scanning specimen
• Broadband Internet for communicating findings
 Cost Benefit

Limitation
• $85,000-$100,000 USD ü The most crucial benefit is
• The Cost of relapse or DR- that lives are saved.
TB will be sufficent ü Mortality rate is lowered.
enough to kickstart this ü Nigeria will finally be free In the experimental research of done
project! from TB betwenn Uganda and Germany[5], they
• The cost of introducing ü The Life expentancy in discovered 2 limitations:
Telepathology is • Speed of Internet
Nigeria is 53 while the
cheaper than the cost • Poorly sectioned, stained and mounted
life expentancy in
of adequately treating Germany is 81. sections from the collection of
a patient specimen.
However, these limitations can be ovecome.
If specimen are carefully collected it will not
be a problem..

The speed of the internet in Nigeria runs

above to 4.5mb/s and this is perfect.
 References
• Nigeria Tuberculosis Fact Sheet. Retrieved June 15th 2020, from
https://photos.state.gov/libraries/nigeria/487468/pdfs/JanuaryTuberculosisFactSheet.pdf
• Mitruka K, Oeltmann JE, Ijaz K, Haddad MB. Tuberculosis outbreak investigations in the United States, 2002-2008. Emerg Infect
Dis. 2011;17(3):425–431.
• [1] Tuberculosis Fact. Retrieved July 1st 2020, from https://www.afro.who.int/news/tuberculosis
• [2]P.Nwadike et al(2018).Unsuccessful Xpert MTB/RIF results: The Nigerian experience. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858060/
• [3]Nigerian Study Confirms that TB is utterly improvished for many people: Retrieved June 30th 2020, from
https://www.afro.who.int/news/nigeria-study-confirms-tb-utterly-impoverishing-manycountry#:~:text=The%20results%20of
%20this%20survey,susceptible%20(DS)%20TB%20patients.
• [4]Telepathology: Retrieved 2nd July 2020, from https://en.wikipedia.org/wiki/Telepathology#:~:text=Telepathology%20is%20the
%20practice%20of,diagnosis%2C%20education%2C%20and%20research.
• [5]D.Wamala et al(2011). Feasibility and diagnostic accuracy of Internet-based dynamic telepathology between Uganda and
Germany. Retrieved from file:///C:/Users/Administrator/Downloads/Wamala_feasibility.pdf
• Robert David Hart(2018).Who’s to blame when a machine botches your surgery? Retrieved from https://qz.com/1367206/whos-to-
blame-when-a-machine-botches-your-surgery/
• AI for Legal: ANI, AGI and ASI: Retrieved June 15th 2020, from https://lawtomated.com/ai-for-lawyers-ani-agi-and-asi/
• W. Nicholson(2019). Risks and remedies for artificial intelligence in health care. Retrieved from
https://www.brookings.edu/research/risks-and-remedies-for-artificial-intelligence-in-health-care/
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