Piloting the use of personal digital assistants for tuberculosis and human immunodeficiency virus surveillance, Kenya, 2007

• Published in: The international journal of tuberculosis and lung disease Vol. 14; no. 9; pp. 1140 - 1146
• Main Authors: AULD, A. F, WAMBUA, N, NAKASHIMA, A, SITIENEI, J, ONYANGO, J, MARSTON, B, NAMULANDA, G, ACKERS, M, OLUOCH, T, KARISA, A, HIGHTOWER, A, SHIRAISHI, R. W
• Format: Journal Article
• Language: English
• Published: Paris, France IUATLD 01-09-2010; International Union against Tuberculosis and Lung Disease
• Subjects: Ambulatory Care Facilities; Anti-Infective Agents - administration & dosage; Anti-Infective Agents - therapeutic use; Bacterial diseases; Biological and medical sciences; Computers, Handheld; HIV Infections - drug therapy; HIV Infections - epidemiology; Human bacterial diseases; Humans; Infectious diseases; Kenya; Kenya - epidemiology; Medical sciences; Mycobacterium; Personal Digital Assistants; Pilot Projects; Pneumology; Population Surveillance - methods; Practice Patterns, Physicians' - standards; Registries - standards; Respiratory system : syndromes and miscellaneous diseases; TB-HIV surveillance; Trimethoprim, Sulfamethoxazole Drug Combination - administration & dosage; Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use; Tuberculosis - drug therapy; Tuberculosis - epidemiology; Tuberculosis and atypical mycobacterial infections; Kenya; Africa; Respiratory disease; Retroviridae; Mycobacterial infection; Kenya; Lentivirus; Infection; Virus; Tuberculosis; Surveillance; Bacteriosis; Human immunodeficiency virus; TB-HIV surveillance; Pneumology; personal digital assistants
• ISSN: 1027-3719; 1815-7920

SETTING: Improved documentation of human immunodeficiency virus (HIV) testing and care among tuberculosis (TB) patients is needed to strengthen TB-HIV programs. In 2007, Kenya piloted the use of personal digital assistants (PDAs) instead of paper registers to collect TB-HIV surveillance
data from TB clinics.OBJECTIVE: To evaluate the acceptability, data quality and usefulness of PDAs.DESIGN: We interviewed four of 31 district coordinators who collected data in PDAs for patients initiating TB treatment from April to June 2007. In 10 of 93 clinics, we randomly selected
patient records for comparison with corresponding records in paper registers or PDAs. Using Cochran-Mantel-Haenszel tests, we compared missing data proportions in paper registers with PDAs. We evaluated PDA usefulness by analyzing PDA data from all 93 clinics.RESULTS: PDAs were well accepted.
Patient records were more frequently missing (28/97 vs. 1/112, P < 0.001) and data fields more frequently incomplete (148/1449 vs. 167/2331, P = 0.03) in PDAs compared with paper registers. PDAs, however, facilitated clinic-level analyses: 48/93 (52%) clinics were not
reaching the targets of testing ≥80% of TB patients for HIV, and 8 (9%) clinics were providing <80% of TB-HIV co-infected patients with cotrimoxazole (CTX).CONCLUSION: PDAs had high rates of missing data but helped identify clinics that were undertesting for HIV or underprescribing
CTX.