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Abaasa A, Mee P, Nanyonjo A, Easton S, Tanser F, Asiki G. Feasibility and acceptability of using biometric fingerprinting to track migrations and support retention in HIV prevention research in fishing population in East Africa. BMC Public Health 2023; 23:2383. [PMID: 38041047 PMCID: PMC10691076 DOI: 10.1186/s12889-023-17339-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 11/25/2023] [Indexed: 12/03/2023] Open
Abstract
INTRODUCTION Fishing populations constitute a suitable key population amongst which to conduct HIV prevention trials due to very high HIV prevalence and incidence, however, these are highly mobile populations. We determined the feasibility and acceptability of using fingerprinting and geographical positioning systems to describe mobility patterns and retention among fisherfolks on the shoreline of Lake Victoria in South-western Uganda. METHODS Between August 2015 and January 2017, two serial cross-sectional surveys were conducted during which fingerprinting of all residents aged 18-30 years on the shoreline of Lake Victoria was done. A mapper moving ahead of the survey team, produced village maps and took coordinates of every household. These were accessed by the survey team that assigned household and individual unique identifiers (ID) and collected demographic data. Using the assigned IDs, individuals were enrolled and their fingerprints scanned. The fingerprinting was repeated 6 months later in order to determine the participant's current household. If it was different from that at baseline, a new household ID was assigned which was used to map migrations both within and between villages. RESULTS At both rounds, over 99% accepted to be fingerprinted. No fingerprinting faults were recorded at baseline and the level was under 1% at round two. Over 80% of the participants were seen at round two and of these, 16.3%, had moved to a new location whilst the majority, 85%, stayed within the same village. Movements between villages were mainly observed for those resident in large villages. Those who did not consider a fishing village to be their permanent home were less likely to be migrants than permanent residents (adjusted odds ratio = 0.37, 95%CI:0.15-0.94). CONCLUSION Use of fingerprinting in fishing populations is feasible and acceptable. It is possible to track this mobile population for clinical trials or health services using this technology since most movements could be traced within and between villages.
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Affiliation(s)
- Andrew Abaasa
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
| | - Paul Mee
- Lincoln International Institute for Rural Health, College of Health and Science, University of Lincoln, Lincoln, UK
| | - Agnes Nanyonjo
- Lincoln International Institute for Rural Health, College of Health and Science, University of Lincoln, Lincoln, UK
| | - Sue Easton
- Lincoln International Institute for Rural Health, College of Health and Science, University of Lincoln, Lincoln, UK
| | - Frank Tanser
- Centre for Epidemic Response and Innovation (CERI), School of Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
| | - Gershim Asiki
- Department of Chronic Diseases Management Unit, Health and Well-being Theme, African Population and Health Research Center, Nairobi, Kenya
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Mittermaier M, Venkatesh KP, Kvedar JC. Digital health technology in clinical trials. NPJ Digit Med 2023; 6:88. [PMID: 37202443 DOI: 10.1038/s41746-023-00841-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/05/2023] [Indexed: 05/20/2023] Open
Affiliation(s)
- Mirja Mittermaier
- Department of Infectious Diseases, Respiratory Medicine and Critical Care, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
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Mistry SK, Akter F, Hossain MB, Huda MN, Irfan NM, Yadav UN, Storisteanu DML, Arora A. Exploring Factors Associated with Women's Willingness to Provide Digital Fingerprints in Accessing Healthcare Services: A Cross-Sectional Study in Urban Slums of Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:40. [PMID: 35010299 PMCID: PMC8751190 DOI: 10.3390/ijerph19010040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 06/14/2023]
Abstract
Digital fingerprints are increasingly used for patient care and treatment delivery, health system monitoring and evaluation, and maintaining data integrity during health research. Yet, no evidence exists about the use of fingerprinting technologies in maternal healthcare services in urban slum contexts, globally. The present study aimed to explore the recently delivered women's willingness to give digital fingerprints to community health workers to access healthcare services in the urban slums of Bangladesh and identify the associated factors. Employing a two-stage cluster random sampling procedure, we chose 458 recently delivered women from eight randomly selected urban slums of Dhaka city, Bangladesh. Chi-square tests were performed for descriptive analyses, and binary logistic regression analyses were performed to explore the factors associated with willingness to provide fingerprints. Overall, 78% of the participants reported that they were willing to provide digital fingerprints if that eased access to healthcare services. After adjusting for potential confounders, the sex of the household head, family type, and household wealth status were significantly associated with the willingness to provide fingerprints to access healthcare services. The study highlighted the potentials of using fingerprints for making healthcare services accessible. Focus is needed for female-headed households, women from poor families, and engaging husbands and in-laws in mobile health programs.
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Affiliation(s)
- Sabuj Kanti Mistry
- BRAC James P Grant School of Public Health, BRAC University, Dhaka 1212, Bangladesh; (S.K.M.); (F.A.); (M.B.H.)
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW 2052, Australia
- Department of Health Research, ARCED Foundation, 13/1, Pallabi, Mirpur-12, Dhaka 1216, Bangladesh
- Department of Public Health, Daffodil International University, Dhaka 1207, Bangladesh
| | - Fahmida Akter
- BRAC James P Grant School of Public Health, BRAC University, Dhaka 1212, Bangladesh; (S.K.M.); (F.A.); (M.B.H.)
| | - Md. Belal Hossain
- BRAC James P Grant School of Public Health, BRAC University, Dhaka 1212, Bangladesh; (S.K.M.); (F.A.); (M.B.H.)
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Md. Nazmul Huda
- School of Health Sciences, Western Sydney University, Campbeltown, NSW 2560, Australia;
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Nafis Md. Irfan
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka 1000, Bangladesh;
- Interdisciplinary Graduate Program in Human Toxicology, University of Iowa, Iowa City, IA 52242, USA
| | - Uday Narayan Yadav
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, ACT 0200, Australia;
| | | | - Amit Arora
- Translational Health Research Institute, Campbelltown Campus, Western Sydney University, Penrith, NSW 2751, Australia
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Penrith, NSW 2751, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
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Bengtson AM, Kumwenda W, Lurie M, Klyn B, Owino M, Miller WC, Go V, Hosseinipour MC. Improving Monitoring of Engagement in HIV Care for Women in Option B+: A Pilot Test of Biometric Fingerprint Scanning in Lilongwe, Malawi. AIDS Behav 2020; 24:551-559. [PMID: 31773445 DOI: 10.1007/s10461-019-02748-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Sustained engagement in HIV care is critical to the success of Option B+ for HIV-infected pregnant women. However, monitoring women's engagement in care across clinics and over time is challenging due to migration and clinic transfers. Improved strategies to identify and monitor women's engagement in HIV care across a network of clinics are needed, but have not been pilot tested. We evaluated the feasibility and acceptability of biometric fingerprint scanning to identify women and monitor HIV visit attendance among women in Option B+. Over a 3-month period, we enrolled HIV-infected pregnant women receiving care at two antenatal clinics in Lilongwe, Malawi and monitored their engagement in care using biometric fingerprint scanning and the standard-of-care electronic medical record (EMR) monitoring system. Biometric data was collected by trained research assistants, who uploaded and synced data across study sites daily using wireless internet. We collected data weekly on the biometric scanner performance, reliability, and usability. We assessed the feasibility and acceptability of using biometric fingerprint scanning to record HIV visits during exit interviews with a sample of participants and healthcare workers and by comparing visit concordance between the biometric fingerprint scanning and EMR systems. We enrolled 314 HIV-infected pregnant women and 51 HCWs (n = 365 total participants). The majority of participants felt the biometric fingerprint scanning system was easy to use (64%), required no additional assistance (69%) and met their expectations (76%). No major issues with data security, privacy, or scanner functionality were reported by HIV-infected women or healthcare workers. Of the 542 HIV visits captured during the study period among women in Option B+, 80% were recorded in the biometric fingerprint system versus 51% in the EMR system (PR 1.57, 95% CI 1.43, 1.72, p-value < 0.05). Among HIV-infected pregnant women engaged in HIV care, biometric fingerprint scanning is a feasible and acceptable way to monitor HIV visits and may improve the ability to monitor women's engagement in HIV care over time and across clinics. Biometric fingerprint scanning should be scaled-up and evaluated as an implementation strategy to support sustained engagement in HIV care for women during the perinatal period.
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Markert K, Krehl K, Gottschlich C, Huckemann S. Detecting anisotropy in fingerprint growth. J R Stat Soc Ser C Appl Stat 2019. [DOI: 10.1111/rssc.12343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kuteesa MO, Weiss HA, Abaasa A, Nash S, Nsubuga RN, Newton R, Seeley J, Kamali A. Feasibility of conducting HIV combination prevention interventions in fishing communities in Uganda: A pilot cluster randomised trial. PLoS One 2019; 14:e0210719. [PMID: 30917121 PMCID: PMC6436767 DOI: 10.1371/journal.pone.0210719] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 01/01/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE We assessed feasibility of an HIV-combination-prevention trial among fishing communities in Uganda. DESIGN Cluster randomised trial in four fishing communities on Lake Victoria, Uganda. Two intervention communities received a combination-prevention-package (behaviour change communication, condom promotion, HIV testing, voluntary male medical circumcision and referral for anti-retroviral therapy if HIV-positive). All four communities received routine government HIV care services. METHODS Using household census data we randomly selected a cohort of consenting residents aged ≥18 years. A baseline sero-survey in July 2014 was followed by two repeat surveys in March and December 2015. We measured uptake of HIV prevention methods, loss-to-follow-up and HIV incidence, accounting for multistage survey design. RESULTS A total of 862 participants were enrolled and followed for 15 months. Participation was 62% and 74% in the control and intervention arms respectively; Overall loss to follow up (LTFU) was 21.6% and was similar by arm. Self-reported abstinence/faithfulness increased between baseline and endline in both arms from 53% to 73% in the control arm, and 55% to 67% in the intervention arm. Reported condom use throughout the study period was 36% in the intervention arm vs 28% in the control arm; number of male participants reporting circumsicion in both arms from 58% to 79% in the intervention arm, and 39% to 46% in the control arm. Independent baseline predictors of loss-to-follow-up were: being HIV positive, residence in the community for <1 year, younger age, living in an urban area, and being away from the area for >1 month/year. CONCLUSIONS Recruitment and retention of participants in longitudinal trials in highly mobile HIV fishing communities is challenging. Future research should investigate modes for locating and retaining participants, and delivery of HIV-combination prevention.
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Affiliation(s)
- Monica O. Kuteesa
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe Uganda
- London School of Hygiene and Tropical Medicine, London United Kingdom
- * E-mail:
| | - Helen A. Weiss
- London School of Hygiene and Tropical Medicine, London United Kingdom
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London United Kingdom
| | - Andrew Abaasa
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe Uganda
- London School of Hygiene and Tropical Medicine, London United Kingdom
| | - Stephen Nash
- London School of Hygiene and Tropical Medicine, London United Kingdom
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London United Kingdom
| | | | - Rob Newton
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe Uganda
| | - Janet Seeley
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe Uganda
- London School of Hygiene and Tropical Medicine, London United Kingdom
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White EB, Meyer AJ, Ggita JM, Babirye D, Mark D, Ayakaka I, Haberer JE, Katamba A, Armstrong-Hough M, Davis JL. Feasibility, Acceptability, and Adoption of Digital Fingerprinting During Contact Investigation for Tuberculosis in Kampala, Uganda: A Parallel-Convergent Mixed-Methods Analysis. J Med Internet Res 2018; 20:e11541. [PMID: 30442637 PMCID: PMC6265600 DOI: 10.2196/11541] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/10/2018] [Accepted: 09/10/2018] [Indexed: 11/30/2022] Open
Abstract
Background In resource-constrained settings, challenges with unique patient identification may limit continuity of care, monitoring and evaluation, and data integrity. Biometrics offers an appealing but understudied potential solution. Objective The objective of this mixed-methods study was to understand the feasibility, acceptability, and adoption of digital fingerprinting for patient identification in a study of household tuberculosis contact investigation in Kampala, Uganda. Methods Digital fingerprinting was performed using multispectral fingerprint scanners. We tested associations between demographic, clinical, and temporal characteristics and failure to capture a digital fingerprint. We used generalized estimating equations and a robust covariance estimator to account for clustering. In addition, we evaluated the clustering of outcomes by household and community health workers (CHWs) by calculating intraclass correlation coefficients (ICCs). To understand the determinants of intended and actual use of fingerprinting technology, we conducted 15 in-depth interviews with CHWs and applied a widely used conceptual framework, the Technology Acceptance Model 2 (TAM2). Results Digital fingerprints were captured for 75.5% (694/919) of participants, with extensive clustering by household (ICC=.99) arising from software (108/179, 60.3%) and hardware (65/179, 36.3%) failures. Clinical and demographic characteristics were not markedly associated with fingerprint capture. CHWs successfully fingerprinted all contacts in 70.1% (213/304) of households, with modest clustering of outcomes by CHWs (ICC=.18). The proportion of households in which all members were successfully fingerprinted declined over time (ρ=.30, P<.001). In interviews, CHWs reported that fingerprinting failures lowered their perceptions of the quality of the technology, threatened their social image as competent health workers, and made the technology more difficult to use. Conclusions We found that digital fingerprinting was feasible and acceptable for individual identification, but problems implementing the hardware and software lead to a high failure rate. Although CHWs found fingerprinting to be acceptable in principle, their intention to use the technology was tempered by perceptions that it was inconsistent and of questionable value. TAM2 provided a valuable framework for understanding the motivations behind CHWs’ intentions to use the technology. We emphasize the need for routine process evaluation of biometrics and other digital technologies in resource-constrained settings to assess implementation effectiveness and guide improvement of delivery.
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Affiliation(s)
- Elizabeth B White
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States
| | - Amanda J Meyer
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States.,Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - Joseph M Ggita
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - Diana Babirye
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - David Mark
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - Irene Ayakaka
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - Jessica E Haberer
- Massachusetts General Hospital Center for Global Health, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Achilles Katamba
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda.,Clinical Epidemiology Unit, Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Mari Armstrong-Hough
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States.,Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - John Lucian Davis
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States.,Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda.,Pulmonary, Critical Care, and Sleep Medicine Section, Yale School of Medicine, New Haven, CT, United States
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Seth R, Akinboyo I, Chhabra A, Qaiyum Y, Shet A, Gupte N, Jain AK, Jain SK. Mobile Phone Incentives for Childhood Immunizations in Rural India. Pediatrics 2018; 141:e20173455. [PMID: 29540571 PMCID: PMC5869335 DOI: 10.1542/peds.2017-3455] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES Young children in resource-poor settings remain inadequately immunized. We evaluated the role of compliance-linked incentives versus mobile phone messaging to improve childhood immunizations. METHODS Children aged ≤24 months from a rural community in India were randomly assigned to either a control group or 1 of 2 study groups. A cloud-based, biometric-linked software platform was used for positive identification, record keeping for all groups, and delivery of automated mobile phone reminders with or without compliance-linked incentives (Indian rupee Rs30 or US dollar $0.50 of phone talk time) for the study groups. Immunization coverage was analyzed by using multivariable Poisson regression. RESULTS Between July 11, 2016, and July 20, 2017, 608 children were randomly assigned to the study groups. Five hundred and forty-nine (90.3%) children fulfilled eligibility criteria, with a median age of 5 months; 51.4% were girls, 83.6% of their mothers had no schooling, and they were in the study for a median duration of 292 days. Median immunization coverage at enrollment was 33% in all groups and increased to 41.7% (interquartile range [IQR]: 23.1%-69.2%), 40.1% (IQR: 30.8%-69.2%), and 50.0% (IQR: 30.8%-76.9%) by the end of the study in the control group, the group with mobile phone reminders, and the compliance-linked incentives group, respectively. The administration of compliance-linked incentives was independently associated with improvement in immunization coverage and a modest increase in timeliness of immunizations. CONCLUSIONS Compliance-linked incentives are an important intervention for improving the coverage and timeliness of immunizations in young children in resource-poor settings.
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Affiliation(s)
| | | | | | | | - Anita Shet
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and
| | - Nikhil Gupte
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ajay K. Jain
- Department of Pediatrics, Cardinal Glennon Children's Medical Center, Saint Louis University School of Medicine, St Louis, Missouri
| | - Sanjay K. Jain
- Departments of Pediatrics and,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and
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Sánchez XMM. [Patient identification errors]. ENFERMERIA CLINICA 2011; 21:295-6. [PMID: 21889387 DOI: 10.1016/j.enfcli.2011.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Accepted: 07/15/2011] [Indexed: 10/17/2022]
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Abstract
EDITORIAL NOTE This review is superseded by the published Cochrane Review, Saif‐Ur‐Rahman 2024 [https://doi.org/10.1002/14651858.CD014573], which considers only the oral killed vaccines because the live oral vaccines do not have World Health Organization (WHO) prequalification. Saif‐Ur‐Rahman 2024 also considered only currently available WHO pre‐qualified oral killed cholera vaccines (Dukoral, Shanchol, and Euvichol/Euvichol‐Plus). BACKGROUND Cholera is a cause of acute watery diarrhoea which can cause dehydration and death if not adequately treated. It usually occurs in epidemics, and is associated with poverty and poor sanitation. Effective, cheap, and easy to administer vaccines could help prevent epidemics. OBJECTIVES To assess the effectiveness and safety of oral cholera vaccines in preventing cases of cholera and deaths from cholera. SEARCH STRATEGY In October 2010, we searched the Cochrane Infectious Disease Group Specialized Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; LILACS; the metaRegister of Controlled Trials (mRCT), and the WHO International Clinical Trials Registry Platform (ICTRP) for relevant published and ongoing trials. SELECTION CRITERIA Randomized or quasi-randomized controlled trials of oral cholera vaccines in healthy adults and children. DATA COLLECTION AND ANALYSIS Each trial was assessed for eligibility and risk of bias by two authors working independently. Data was extracted by two independent reviewers and analysed using the Review Manager 5 software. Outcomes are reported as vaccine protective efficacy (VE) with 95% confidence intervals (CIs). MAIN RESULTS Seven large efficacy trials, four small artificial challenge studies, and twenty-nine safety trials contributed data to this review.Five variations of a killed whole cell vaccine have been evaluated in large scale efficacy trials (four trials, 249935 participants). The overall vaccine efficacy during the first year was 52% (95% CI 35% to 65%), and during the second year was 62% (95% CI 51% to 62%). Protective efficacy was lower in children aged less than 5 years; 38% (95% CI 20% to 53%) compared to older children and adults; 66% (95% CI 57% to 73%).One trial of a killed whole cell vaccine amongst military recruits demonstrated 86% protective efficacy (95% CI 37% to 97%) in a small epidemic occurring within 4 weeks of the 2-dose schedule (one trial, 1426 participants). Efficacy data is not available beyond two years for the currently available vaccine formulations, but based on data from older trials is unlikely to last beyond three years.The safety data available on killed whole cell vaccines have not demonstrated any clinically significant increase in adverse events compared to placebo.Only one live attenuated vaccine has reached Phase III clinical evaluation and was not effective (one trial, 67508 participants). Two new candidate live attenuated vaccines have demonstrated clinical effectiveness in small artificial challenge studies, but are still in development. AUTHORS' CONCLUSIONS The currently available oral killed whole cell vaccines can prevent 50 to 60% of cholera episodes during the first two years after the primary vaccination schedule. The impact and cost-effectiveness of adopting oral cholera vaccines into the routine vaccination schedule of endemic countries will depend on the prevalence of cholera, the frequency of epidemics, and access to basic services providing rapid rehydration therapy.
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Affiliation(s)
- David Sinclair
- International Health Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK, L3 5QA
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Serwaa-Bonsu A, Herbst AJ, Reniers G, Ijaa W, Clark B, Kabudula C, Sankoh O. First experiences in the implementation of biometric technology to link data from Health and Demographic Surveillance Systems with health facility data. Glob Health Action 2010; 3. [PMID: 20200659 PMCID: PMC2830803 DOI: 10.3402/gha.v3i0.2120] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Revised: 01/26/2010] [Accepted: 01/26/2010] [Indexed: 11/14/2022] Open
Abstract
Background In developing countries, Health and Demographic Surveillance Systems (HDSSs) provide a framework for tracking demographic and health dynamics over time in a defined geographical area. Many HDSSs co-exist with facility-based data sources in the form of Health Management Information Systems (HMIS). Integrating both data sources through reliable record linkage could provide both numerator and denominator populations to estimate disease prevalence and incidence rates in the population and enable determination of accurate health service coverage. Objective To measure the acceptability and performance of fingerprint biometrics to identify individuals in demographic surveillance populations and those attending health care facilities serving the surveillance populations. Methodology Two HDSS sites used fingerprint biometrics for patient and/or surveillance population participant identification. The proportion of individuals for whom a fingerprint could be successfully enrolled were characterised in terms of age and sex. Results Adult (18–65 years) fingerprint enrolment rates varied between 94.1% (95% CI 93.6–94.5) for facility-based fingerprint data collection at the Africa Centre site to 96.7% (95% CI 95.9–97.6) for population-based fingerprint data collection at the Agincourt site. Fingerprint enrolment rates in children under 1 year old (Africa Centre site) were only 55.1% (95% CI 52.7–57.4). By age 5, child fingerprint enrolment rates were comparable to those of adults. Conclusion This work demonstrates the feasibility of fingerprint-based individual identification for population-based research in developing countries. Record linkage between demographic surveillance population databases and health care facility data based on biometric identification systems would allow for a more comprehensive evaluation of population health, including the ability to study health service utilisation from a population perspective, rather than the more restrictive health service perspective.
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Affiliation(s)
- Adwoa Serwaa-Bonsu
- School of Technology, Ghana Institute of Management and Public Administration, Accra, Ghana
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