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. 2022 Aug 22;7(8):201.
doi: 10.3390/tropicalmed7080201.

Factors Affecting the Transition from Paper to Digital Data Collection for Mobile Tuberculosis Active Case Finding in Low Internet Access Settings in Pakistan

Christina Mergenthaler  1 , Jake D Mathewson  1 , Abdullah Latif  2 , Hasan Tahir  3 , Vincent Meurrens  4 , Andreas van Werle  4 , Aamna Rashid  3 , Muhammad Tariq  3 , Tanveer Ahmed  2 , Farah Naureen  3 , Ente Rood  1
Affiliations

Factors Affecting the Transition from Paper to Digital Data Collection for Mobile Tuberculosis Active Case Finding in Low Internet Access Settings in Pakistan

Christina Mergenthaler et al. Trop Med Infect Dis. .

Abstract

Between September 2020 and March 2021, Mercy Corps piloted hybrid digital (CAPI) and paper-based (PAPI) data collection as part of its tuberculosis (TB) active case finding strategy. Data were collected using CAPI and PAPI at 140 TB chest camps in low Internet access areas of Punjab and Khyber Pakhtunkhwa provinces in Pakistan. PAPI data collection was performed primarily during the camp and entered using a tailor-performed CAPI tool after camps. To assess the feasibility of this hybrid approach, quality of digital records were measured against the paper "gold standard", and user acceptance was evaluated through focus group discussions. Completeness of digital data varied by indicator, van screening team, and month of implementation: chest camp attendees and pulmonary TB cases showed the highest CAPI/PAPI completeness ratios (1.01 and 0.96 respectively), and among them, all forms of TB diagnosis and treatment initiation were lowest (0.63 and 0.64 respectively). Vans entering CAPI data with high levels of completeness generally did so for all indicators, and significant differences in mean indicator completeness rates between PAPI and CAPI were observed between vans. User feedback suggested that although the CAPI tool required practice to gain proficiency, the technology was appreciated and will be better perceived once double entry in CAPI and PAPI can transition to CAPI only. CAPI data collection enables data to be entered in a more timely fashion in low-Internet-access settings, which will enable more rapid, evidence-based program steering. The current system in which double data entry is conducted to ensure data quality is an added burden for staff with many activities. Transitioning to a fully digital data collection system for TB case finding in low-Internet-access settings requires substantial investments in M&E support, shifts in data reporting accountability, and technology to link records of patients who pass through separate data collection stages during chest camp events.

Keywords: CAPI; PAPI; active case finding; data quality; digital tools; tuberculosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Intervention Area for Hybrid CAPI/PAPI Data Collection in Chest Camps, Pakistan (September 2020–March 2021).
Figure 2
Figure 2
Chest camp intervention logic and flow of participants and data.
Figure 3
Figure 3
Median and interquartile ranges of mean differences between PAPI and CAPI chest camp indicators. * Significant difference (p < 0.05) in mean values reported between PAPI and CAPI.
Figure 4
Figure 4
Consistency of CAPI and PAPI indicators Per van (PAPI-CAPI). (a) People verbally screened; (b) people receiving chest X-ray; (c) people identified with presumptive TB. * Significant difference (p < 0.05) in mean values reported between PAPI and CAPI.
Figure 5
Figure 5
Proportion of CAPI chest camps reporting 100% of data correctly based on PAPI data, per indicator by month.
See this image and copyright information in PMC

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