• Effects of real-time electronic data entry on HIV programme data quality in Lusaka, Zambia

      Moomba, K; Williams, A; Savory, T; Lumpa, M; Chilembo, P; Tweya, H; Harries, AD; Herce, M (International Union Against Tuberculosis and Lung Disease, 2020-03-21)
      Setting: Human immunodeficiency virus (HIV) clinics in five hospitals and five health centres in Lusaka, Zambia, which transitioned from daily entry of paper-based data records to an electronic medical record (EMR) system by dedicated data staff (Electronic-Last) to direct real-time data entry into the EMR by frontline health workers (Electronic-First). Objective: To compare completeness and accuracy of key HIV-related variables before and after transition of data entry from Electronic-Last to Electronic-First. Design: Comparative cross-sectional study using existing secondary data. Results: Registration data (e.g., date of birth) was 100% complete and pharmacy data (e.g., antiretroviral therapy regimen) was 90% complete under both approaches. Completeness of anthropometric and vital sign data was 75% across all facilities under Electronic-Last, and this worsened after Electronic-First. Completeness of TB screening and World Health Organization clinical staging data was also 75%, but improved with Electronic-First. Data entry errors for registration and clinical consultations decreased under Electronic-First, but errors increased for all anthropometric and vital sign variables. Patterns were similar in hospitals and health centres. Conclusion: With the notable exception of clinical consultation data, data completeness and accuracy did not improve after transitioning from Electronic-Last to Electronic-First. For anthropometric and vital sign variables, completeness and accuracy decreased. Quality improvement interventions are needed to improve Electronic-First implementation.
    • Hidden dangers-prevalence of blood borne pathogens, hepatitis B, C, HIV and syphilis, among blood donors in Sierra Leone in 2016: opportunities for improvement: a retrospective, cross-sectional study.

      Yambasu, EE; Reid, A; Owiti, P; Manzi, M; Murray, MJS; Edwin, AK (African Field Epidemiology Network, 2018-05-18)
      INTRODUCTION: Transmissible blood-borne infections are a serious threat to blood transfusion safety in West African countries; and yet blood remains a key therapeutic product in the clinical management of patients. Sierra Leone screens blood donors for blood-borne infections but has not implemented prevention of mother-to-child transmission for hepatitis B. This study aimed to describe the overall prevalence of hepatitis B and C, HIV and syphilis among blood donors in Sierra Leone in 2016 and to compare the differences between volunteer versus family replacement donors, as well as urban versus rural donors. METHODS: Retrospective, cross-sectional study from January-December 2016 in five blood bank laboratories across the country. Routinely-collected programme data were analyzed; blood donors were tested with rapid diagnostic tests-HBsAg for HBV, anti-HCV antibody for HCV, antibodies HIV1&2 for HIV and TPHA for syphilis. RESULTS: There were 16807 blood samples analysed, with 80% from males; 2285 (13.6%) tested positive for at least one of the four pathogens. Overall prevalence was: 9.7% hepatitis B; 1.0% hepatitis C; 2.8% HIV; 0.8% syphilis. Prevalence was higher among samples from rural blood banks, the difference most marked for hepatitis C. The proportion of voluntary donors was 12%. Family replacement donors had a higher prevalence of hepatitis B, C and HIV than volunteers. CONCLUSION: A high prevalence of blood-borne pathogens, particularly hepatitis B, was revealed in Sierra Leone blood donors. The study suggests the country should implement the prevention of mother-to-child transmission of hepatitis B and push to recruit more volunteer, non-remunerated blood donors.