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Haque M, Islam T, Rahman NAA, McKimm J, Abdullah A, Dhingra S. Strengthening Primary Health-Care Services to Help Prevent and Control Long-Term (Chronic) Non-Communicable Diseases in Low- and Middle-Income Countries. Risk Manag Healthc Policy 2020; 13:409-426. [PMID: 32547272 PMCID: PMC7244358 DOI: 10.2147/rmhp.s239074] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 03/24/2020] [Indexed: 12/31/2022] Open
Abstract
The prevalence of long-term (chronic) non-communicable diseases (NCDs) is increasing globally due to an ageing global population, urbanization, changes in lifestyles, and inequitable access to healthcare. Although previously more common in high- and upper-middle-income countries, lower-middle-income countries (LMICs) are more affected, with NCDs in LMICs currently accounting for 85–90% of premature deaths among 30–69 years old. NCDs have both high morbidity and mortality and high treatment costs, not only for the diseases themselves but also for their complications. Primary health care (PHC) services are a vital component in the prevention and control of long-term NCDs, particularly in LMICs, where the health infrastructure and hospital services may be under strain. Drawing from published studies, this review analyses how PHC services can be utilized and strengthened to help prevent and control long-term NCDs in LMICs. The review finds that a PHC service approach, which deals with health in a comprehensive way, including the promotion, prevention, and control of diseases, can be useful in both high and low resource settings. Further, a PHC based approach also provides opportunities for communities to better access appropriate healthcare, which ensures more significant equity, efficiency, effectiveness, safety, and timeliness, empowers service users, and helps healthcare providers to achieve better health outcomes at lower costs. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/33l6gK1RNFo
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Affiliation(s)
- Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, (National Defence University of Malaysia), Kuala Lumpur 57000, Malaysia
| | - Tariqul Islam
- UChicago Research Bangladesh, Dhaka 1230, Bangladesh
| | - Nor Azlina A Rahman
- Department of Physical Rehabilitation Sciences, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Kuantan, 25200, Malaysia
| | - Judy McKimm
- Swansea University School of Medicine, Swansea University, Swansea, Wales SA2 8PP, UK
| | - Adnan Abdullah
- Unit of Occupational Medicine, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, (National Defence University of Malaysia), Kuala Lumpur 57000, Malaysia
| | - Sameer Dhingra
- School of Pharmacy, Faculty of Medical Sciences, The University of the West Indies, St. Augustine Campus, Mount Hope, Trinidad & Tobago
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Faridah L, Rinawan FR, Fauziah N, Mayasari W, Dwiartama A, Watanabe K. Evaluation of Health Information System (HIS) in The Surveillance of Dengue in Indonesia: Lessons from Case in Bandung, West Java. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051795. [PMID: 32164243 PMCID: PMC7084631 DOI: 10.3390/ijerph17051795] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/03/2020] [Accepted: 03/06/2020] [Indexed: 11/18/2022]
Abstract
This study was performed to evaluate the health information system regarding the dengue surveillance system in Indonesia. Major obstacles to the implementation of an effective health information system regarding dengue cases in Bandung are examined, and practical suggestions on measures to overcome them are discussed. The study utilized a mixed-method research design using qualitative approaches: document analysis, key informants and focus group interviews. Thirty key informants were selected, comprised of policymakers, senior managers, and staff at the Ministry of Health. Data from documents and transcripts were evaluated through a modified Institutional Analysis and Development (IAD) framework described by Ostrom. Through this study, we have identified several issues that hinder the effective implementation of the health information system in the case of dengue in Bandung. In the end, we propose several recommendations for reform that encompasses motivational, strategic, and structural approaches to each component of the analysis. Through evaluation of the health information system for dengue surveillance in Indonesia, we conclude that well-coordination in multi-level governance in a country as large as Indonesia is the key in the implementation of the health information system in different levels of agencies. Furthermore, the adaptability of human resources in adopting a new information system also plays an important part.
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Affiliation(s)
- Lia Faridah
- Parasitology Division, Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, Indonesia;
- Foreign Visiting Researcher at Department of Civil and Environmental Engineering, Ehime University, Matsuyama, Ehime 790-8577, Japan
- Correspondence:
| | - Fedri Ruluwedrata Rinawan
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, Indonesia;
| | - Nisa Fauziah
- Parasitology Division, Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, Indonesia;
| | - Wulan Mayasari
- Anatomy Division, Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, Indonesia;
| | - Angga Dwiartama
- School of Life Sciences and Technology, Institut Teknologi Bandung, Bandung 40132, Indonesia;
| | - Kozo Watanabe
- Department of Civil and Environmental Engineering, Ehime University, Matsuyama, Ehime 790-8577, Japan;
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Gibson AD, Mazeri S, Lohr F, Mayer D, Burdon Bailey JL, Wallace RM, Handel IG, Shervell K, Bronsvoort BM, Mellanby RJ, Gamble L. One million dog vaccinations recorded on mHealth innovation used to direct teams in numerous rabies control campaigns. PLoS One 2018; 13:e0200942. [PMID: 30048469 PMCID: PMC6062050 DOI: 10.1371/journal.pone.0200942] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 07/05/2018] [Indexed: 12/25/2022] Open
Abstract
Background Canine transmitted rabies kills an estimated 59,000 people annually, despite proven methods for elimination through mass dog vaccination. Challenges in directing and monitoring numerous remote vaccination teams across large geographic areas remain a significant barrier to the up-scaling of focal vaccination programmes to sub-national and national level. Smartphone technology (mHealth) is increasingly being used to enhance the coordination and efficiency of public health initiatives in developing countries, however examples of successful scaling beyond pilot implementation are rare. This study describes a smartphone app and website platform, “Mission Rabies App”, used to co-ordinate rabies control activities at project sites in four continents to vaccinate over one million dogs. Methods Mission Rabies App made it possible to not only gather relevant campaign data from the field, but also to direct vaccination teams systematically in near real-time. The display of user-allocated boundaries on Google maps within data collection forms enabled a project manager to define each team’s region of work, assess their output and assign subsequent areas to progressively vaccinate across a geographic area. This ability to monitor work and react to a rapidly changing situation has the potential to improve efficiency and coverage achieved, compared to regular project management structures, as well as enhancing capacity for data review and analysis from remote areas. The ability to plot the location of every vaccine administered facilitated engagement with stakeholders through transparent reporting, and has the potential to motivate politicians to support such activities. Results Since the system launched in September 2014, over 1.5 million data entries have been made to record dog vaccinations, rabies education classes and field surveys in 16 countries. Use of the system has increased year-on-year with adoption for mass dog vaccination campaigns at the India state level in Goa and national level in Haiti. Conclusions Innovative approaches to rapidly scale mass dog vaccination programmes in a sustained and systematic fashion are urgently needed to achieve the WHO, OIE and FAO goal to eliminate canine-transmitted human deaths by 2030. The Mission Rabies App is an mHealth innovation which greatly reduces the logistical and managerial barriers to implementing large scale rabies control activities. Free access to the platform aims to support pilot campaigns to better structure and report on proof-of-concept initiatives, clearly presenting outcomes and opportunities for expansion. The functionalities of the Mission Rabies App may also be beneficial to other infectious disease interventions.
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Affiliation(s)
- Andrew D. Gibson
- Mission Rabies, Cranborne, Dorset, United Kingdom
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, Division of Genetics and Genomics, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, United Kingdom
| | - Stella Mazeri
- Mission Rabies, Cranborne, Dorset, United Kingdom
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, Division of Genetics and Genomics, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, United Kingdom
| | | | - Dagmar Mayer
- Worldwide Veterinary Service, Cranborne, Dorset, United Kingdom
| | | | - Ryan M. Wallace
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ian G. Handel
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, Division of Genetics and Genomics, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, United Kingdom
| | | | - Barend M.deC. Bronsvoort
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, Division of Genetics and Genomics, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, United Kingdom
| | - Richard J. Mellanby
- The Royal (Dick) School of Veterinary Studies, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, United Kingdom
- * E-mail: (RJM); (LG)
| | - Luke Gamble
- Mission Rabies, Cranborne, Dorset, United Kingdom
- Worldwide Veterinary Service, Cranborne, Dorset, United Kingdom
- * E-mail: (RJM); (LG)
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Park JY, Kim DR, Haldar B, Mallick AH, Kim SA, Dey A, Nandy RK, Paul DK, Choudhury S, Sahoo S, Wierzba TF, Sur D, Kanungo S, Ali M, Manna B. Use of the data system for field management of a clinical study conducted in Kolkata, India. BMC Res Notes 2016; 9:20. [PMID: 26749186 PMCID: PMC4706999 DOI: 10.1186/s13104-015-1767-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 11/30/2015] [Indexed: 11/26/2022] Open
Abstract
Background
Designing an appropriate data system is important to the success of a clinical study. However, little information is available on this topic. We share our experiences on designing, developing, and implementation of a data system for management of data and field activities of a complex clinical study. Methods The data system was implemented aiming at determining the biological basis for the underperformance of oral vaccines, such as polio and rotavirus vaccines in children at a site in Kolkata, India. The system included several functionalities to control data and field activities. It was restricted to authorized users based on their access privileges. A relational database platform was chosen, and Microsoft Visual FoxPro 7.0 (Microsoft Corporation, Seattle, WA, USA) was used to develop the system. The system was installed at the clinic and data office to facilitate both the field and data management activities. Results Data were doubly entered by two different data operators to identify keypunching errors in the data. Outliers, duplication, inconsistencies, missing entries, and linkage were also checked. Every modification and users log-in/log-out information was auto-recorded in an audit trail. The system offered tools for preparation of visit schedule of the participants. A visit considered as protocol deviation was documented by the system. The system alerted field staff to every upcoming visit date to organize the field activities and to inform participants which day to come. The system also produced a growth chart for evaluating nutritional status and referring the child to a specialized clinic if found to be severely malnourished. Conclusion The data system offered unique features for controlling for both data and field activities, which led to minimize drop-out rates as well as protocol deviations. Such system is warranted for a successful clinical study.
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Affiliation(s)
- Ju Yeon Park
- International Vaccine Institute, Seoul, South Korea.
| | - Deok Ryun Kim
- International Vaccine Institute, Seoul, South Korea.
| | - Bisakha Haldar
- National Institute of Cholera and Enteric Diseases, Kolkata, India.
| | | | - Soon Ae Kim
- International Vaccine Institute, Seoul, South Korea.
| | - Ayan Dey
- International Vaccine Institute, Seoul, South Korea.
| | | | - Dilip Kumar Paul
- B.C. Roy Post Graduate Institute of Pediatric Sciences, Kolkata, India.
| | - Saugata Choudhury
- B.C. Roy Post Graduate Institute of Pediatric Sciences, Kolkata, India.
| | - Shushama Sahoo
- B.C. Roy Post Graduate Institute of Pediatric Sciences, Kolkata, India.
| | - Thomas F Wierzba
- International Vaccine Institute, Seoul, South Korea. .,PATH, Washington, DC, USA.
| | - Dipika Sur
- National Institute of Cholera and Enteric Diseases, Kolkata, India.
| | - Suman Kanungo
- National Institute of Cholera and Enteric Diseases, Kolkata, India.
| | - Mohammad Ali
- International Vaccine Institute, Seoul, South Korea. .,Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
| | - Byomkesh Manna
- National Institute of Cholera and Enteric Diseases, Kolkata, India.
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Davey S, Davey A. Effect of practice management softwares among physicians of developing countries with special reference to Indian scenario by Mixed Method Technique. J Family Med Prim Care 2015; 4:208-16. [PMID: 25949969 PMCID: PMC4408703 DOI: 10.4103/2249-4863.154637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction: Currently, many cheaper “practice management software” (PMS) are available in developing countries including India; despite their availability and benefits, its penetration and usage vary from low to moderate level, justifying the importance of this study area. Materials and Methods: First preferred reporting items for systematic-review and meta-analysis (2009) guidelines were considered; followed by an extensive systematic-review of available studies in literature related to developing countries, on key search term from main abstracting databases: PubMed, EMBASE, EBSCO, BIO-MED Central, Cochrane Library, world CAT-library till 15 June 2014; where any kind of article whether published or unpublished, in any sort or form or any language indicating the software usage were included. Thereafter, meta-analysis on Indian studies revealing the magnitude of usage in Indian scenario by Open Meta-(analyst) software using binary random effects (REs) model was done. Studies from developed countries were excluded in our study. Results: Of 57 studies included in a systematic review from developing countries, only 4 Indian studies were found eligible for meta-analysis. RE model revealed although not-significant results (total participants = 243,526; range: 100–226,228, overall odds ratio = 2.85, 95% confidence interval = P < 0.05 and tests for heterogeneity: Q [df = 3] = 0.8 Het. P = 0.85). The overall magnitude of usage of PMS on Indian physicians practice was however found between 10% and 45%. Conclusion: Although variable and nonsignificant effect of usage of PM software on practice of physicians in developing countries like India was found; there is a need to recognize the hidden potential of this system. Hence, more in-depth research in future needs to be done, in order to find a real impact of this system.
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Affiliation(s)
- Sanjeev Davey
- Department of Community Medicine, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, India
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Using Mobile Health (mHealth) and geospatial mapping technology in a mass campaign for reactive oral cholera vaccination in rural Haiti. PLoS Negl Trop Dis 2014; 8:e3050. [PMID: 25078790 PMCID: PMC4117440 DOI: 10.1371/journal.pntd.0003050] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 06/16/2014] [Indexed: 11/19/2022] Open
Abstract
Background In mass vaccination campaigns, large volumes of data must be managed efficiently and accurately. In a reactive oral cholera vaccination (OCV) campaign in rural Haiti during an ongoing epidemic, we used a mobile health (mHealth) system to manage data on 50,000 participants in two isolated communities. Methods Data were collected using 7-inch tablets. Teams pre-registered and distributed vaccine cards with unique barcodes to vaccine-eligible residents during a census in February 2012. First stored on devices, data were uploaded nightly via Wi-fi to a web-hosted database. During the vaccination campaign between April and June 2012, residents presented their cards at vaccination posts and their barcodes were scanned. Vaccinee data from the census were pre-loaded on tablets to autopopulate the electronic form. Nightly analysis of the day's community coverage informed the following day's vaccination strategy. We generated case-finding reports allowing us to identify those who had not yet been vaccinated. Results During 40 days of vaccination, we collected approximately 1.9 million pieces of data. A total of 45,417 people received at least one OCV dose; of those, 90.8% were documented to have received 2 doses. Though mHealth required up-front financial investment and training, it reduced the need for paper registries and manual data entry, which would have been costly, time-consuming, and is known to increase error. Using Global Positioning System coordinates, we mapped vaccine posts, population size, and vaccine coverage to understand the reach of the campaign. The hardware and software were usable by high school-educated staff. Conclusion The use of mHealth technology in an OCV campaign in rural Haiti allowed timely creation of an electronic registry with population-level census data, and a targeted vaccination strategy in a dispersed rural population receiving a two-dose vaccine regimen. The use of mHealth should be strongly considered in mass vaccination campaigns in future initiatives. The World Health Organization (WHO) recently endorsed the creation of a global oral cholera vaccine (OCV) stockpile as part of an integrated, strategic framework to address the re-emerging threat that cholera causes worldwide. In conjunction, the WHO also called for continued monitoring and evaluation around the use of OCV in different settings. In response to the cholera epidemic in Haiti that began in October 2010, Partners In Health, an implementing partner of Haiti's Ministry of Health, vaccinated 50,000 Haitians in two rural communities in the Artibonite Valley in 2012. In this paper, the authors describe the use of mobile health (mHealth) technology for data collection and geospatial mapping to document this rural OCV campaign, focusing on the utility, benefits, and challenges of mHealth in a reactive campaign in the midst of the ongoing epidemic.
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Collection, verification, sharing and dissemination of data: the CONTRAST experience. Acta Trop 2013; 128:407-11. [PMID: 23707729 DOI: 10.1016/j.actatropica.2013.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 05/14/2013] [Accepted: 05/15/2013] [Indexed: 11/21/2022]
Abstract
The scientific community is charged with growing demands regarding the management of project data and outputs and the dissemination of key results to various stakeholders. We discuss experiences and lessons from CONTRAST, a multidisciplinary alliance that had been funded by the European Commission over a 4-year period, in order to optimize schistosomiasis control and transmission surveillance in sub-Saharan Africa. From the start, project partners from Europe and Africa set out an ambitious goal: to sample data following standard protocols at all field sites and then sharing the data in a way that would enable all project partners to have access through a password-protected Internet-based data portal. This required anonymous agreement on several common standardized sample forms, ranging from the mundane but important issue of using the same units of measurement to more complex challenges, for instance agreeing on the same protocols for double-treatment of praziquantel in different settings. With the experiences gained by the CONTRAST project, this paper discusses issues of data management and sharing in research projects in the light of the current donor demand, and offers advice and specific suggestions for similar interdisciplinary research projects.
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Data base management system for lymphatic filariasis--a neglected tropical disease. PLoS One 2012; 7:e39970. [PMID: 22792200 PMCID: PMC3390335 DOI: 10.1371/journal.pone.0039970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 06/05/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Researchers working in the area of Public Health are being confronted with large volumes of data on various aspects of entomology and epidemiology. To obtain the relevant information out of these data requires particular database management system. In this paper, we have described about the usages of our developed database on lymphatic filariasis. METHODS This database application is developed using Model View Controller (MVC) architecture, with MySQL as database and a web based interface. We have collected and incorporated the data on filariasis in the database from Karimnagar, Chittoor, East and West Godavari districts of Andhra Pradesh, India. CONCLUSION The importance of this database is to store the collected data, retrieve the information and produce various combinational reports on filarial aspects which in turn will help the public health officials to understand the burden of disease in a particular locality. This information is likely to have an imperative role on decision making for effective control of filarial disease and integrated vector management operations.
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Araujo de Carvalho EC, Batilana AP, Claudino W, Lima Reis LF, Schmerling RA, Shah J, Pietrobon R. Workflow in clinical trial sites & its association with near miss events for data quality: ethnographic, workflow & systems simulation. PLoS One 2012; 7:e39671. [PMID: 22768105 PMCID: PMC3387261 DOI: 10.1371/journal.pone.0039671] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 05/29/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND With the exponential expansion of clinical trials conducted in (Brazil, Russia, India, and China) and VISTA (Vietnam, Indonesia, South Africa, Turkey, and Argentina) countries, corresponding gains in cost and enrolment efficiency quickly outpace the consonant metrics in traditional countries in North America and European Union. However, questions still remain regarding the quality of data being collected in these countries. We used ethnographic, mapping and computer simulation studies to identify/address areas of threat to near miss events for data quality in two cancer trial sites in Brazil. METHODOLOGY/PRINCIPAL FINDINGS Two sites in Sao Paolo and Rio Janeiro were evaluated using ethnographic observations of workflow during subject enrolment and data collection. Emerging themes related to threats to near miss events for data quality were derived from observations. They were then transformed into workflows using UML-AD and modeled using System Dynamics. 139 tasks were observed and mapped through the ethnographic study. The UML-AD detected four major activities in the workflow evaluation of potential research subjects prior to signature of informed consent, visit to obtain subject́s informed consent, regular data collection sessions following study protocol and closure of study protocol for a given project. Field observations pointed to three major emerging themes: (a) lack of standardized process for data registration at source document, (b) multiplicity of data repositories and (c) scarcity of decision support systems at the point of research intervention. Simulation with policy model demonstrates a reduction of the rework problem. CONCLUSIONS/SIGNIFICANCE Patterns of threats to data quality at the two sites were similar to the threats reported in the literature for American sites. The clinical trial site managers need to reorganize staff workflow by using information technology more efficiently, establish new standard procedures and manage professionals to reduce near miss events and save time/cost. Clinical trial sponsors should improve relevant support systems.
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Affiliation(s)
- Elias Cesar Araujo de Carvalho
- Research on Research Group, Department of Surgery, Duke University, Durham, North Carolina, United States of America
- Cesumar, Universitary Center of Maringa, Paraná, Brazil
- UEM, State University of Maringa, Paraná, Brazil
| | - Adelia Portero Batilana
- Research on Research Group, Department of Surgery, Duke University, Durham, North Carolina, United States of America
| | | | | | | | - Jatin Shah
- Research on Research Group, Duke-NUS Graduate Medical School, Singapore, Singapore
- Research on Research Group, Duke University, Durham, North Carolina, United States of America
| | - Ricardo Pietrobon
- Department of Surgery, Duke University Health System, Durham, North Carolina, United States of America
- Duke - NUS Graduate Medical School, Singapore, Singapore
- Research on Research Group, Duke University, Durham, North Carolina, United States of America
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The data management of a phase III efficacy trial of an 11-valent pneumococcal conjugate vaccine and related satellite studies conducted in the Philippines. BMC Res Notes 2012; 5:274. [PMID: 22676626 PMCID: PMC3434041 DOI: 10.1186/1756-0500-5-274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 05/11/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A large phase III placebo-controlled, randomized efficacy trial of an investigational 11-valent pneumococcal conjugate vaccine against pneumonia in children less than 2 years of age was conducted in the Philippines from July 2000 to December 2004. Clinical data from 12,194 children who were given either study vaccine or placebo was collected from birth up to two years of age for the occurrence of radiologically proven pneumonia as the primary endpoint, and for clinical pneumonia and invasive pneumococcal disease as the secondary endpoints. Several tertiary endpoints were also explored. Along the core trial, several satellite studies on herd immunity, cost-effectiveness of the study vaccine, acute otitis media, and wheezing were conducted. RESULTS We describe here in detail how the relevant clinical records were managed and how quality control procedures were implemented to ensure that valid data were obtained respectively for the core trial and for the satellite studies. We discuss how the task was achieved, what the challenges were and what might have been done differently. CONCLUSIONS There were several factors that made the task of data management doable and efficient. First, a pre-trial data management system was available. Secondly, local committed statisticians, programmers and support staff were available and partly familiar to clinical trials. Thirdly, the personnel had undergone training during trial and grew with the task they were supposed to do. Thus the knowledge needed to develop and operate clinical data system was fully transferred to local staff. TRIAL REGISTRATION Current Controlled Trials ISRCTN62323832.
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Ali M, Deen JL, Khatib A, Enwere G, von Seidlein L, Reyburn R, Ali SM, Chang NY, Perroud V, Marodon F, Saleh AA, Hashim R, Lopez AL, Beard J, Ley BN, Thriemer K, Puri MK, Sah B, Jiddawi MS, Clemens JD. Paperless registration during survey enumerations and large oral cholera mass vaccination in Zanzibar, the United Republic of Tanzania. Bull World Health Organ 2010; 88:556-9. [PMID: 20616976 DOI: 10.2471/blt.09.070334] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Revised: 10/07/2009] [Accepted: 10/22/2009] [Indexed: 11/27/2022] Open
Abstract
PROBLEM Field trials require extensive data preparation and complex logistics. The use of personal digital assistants (PDAs) can bypass many of the traditional steps that are necessary in a paper-based data entry system. APPROACH We programmed, designed and supervised the use of PDAs for a large survey enumeration and mass vaccination campaign. LOCAL SETTING The project was implemented in Zanzibar in the United Republic of Tanzania. Zanzibar is composed of two main islands, Unguja and Pemba, where outbreaks of cholera have been reported since the 1970s. RELEVANT CHANGES PDAs allowed us to digitize information at the initial point of contact with the respondents. Immediate response by the system in case of error helped ensure the quality and reliability of the data. PDAs provided quick data summaries that allowed subsequent research activities to be implemented in a timely fashion. LESSONS LEARNT Portability, immediate recording and linking of information enhanced structure data collection in our study. PDAs could be more useful than paper-based systems for data collection in the field, especially in impoverished settings in developing countries.
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Affiliation(s)
- Mohammad Ali
- International Vaccine Institute, Kwanak PO Box-14, Seoul, 151-600, Republic of Korea.
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