title: Implementation of an electronic fingerprint-linked data collection system: a feasibility and acceptability study among Zambian female sex workers.
abstract: BACKGROUND
  Patient identification within and between health services is an operational challenge in many resource-limited settings. When following HIV risk groups for service provision and in the context of vaccine trials, patient misidentification can harm patient care and bias trial outcomes. Electronic fingerprinting has been proposed to identify patients over time and link patient data between health services. The objective of this study was to determine 1) the feasibility of implementing an electronic-fingerprint linked data capture system in Zambia and 2) the acceptability of this system among a key HIV risk group: female sex workers (FSWs).
  
  
  METHODS
  Working with Biometrac, a US-based company providing biometric-linked healthcare platforms, an electronic fingerprint-linked data capture system was developed for use by field recruiters among Zambian FSWs. We evaluated the technical feasibility of the system for use in the field in Zambia and conducted a pilot study to determine the acceptability of the system, as well as barriers to uptake, among FSWs.
  
  
  RESULTS
  We found that implementation of an electronic fingerprint-linked patient tracking and data collection system was feasible in this relatively resource-limited setting (false fingerprint matching rate of 1/1000 and false rejection rate of <1/10,000) and was acceptable among FSWs in a clinic setting (2% refusals). However, our data indicate that less than half of FSWs are comfortable providing an electronic fingerprint when recruited while they are working. The most common reasons cited for not providing a fingerprint (lack of privacy/confidentiality issues while at work, typically at bars or lodges) could be addressed by recruiting women during less busy hours, in their own homes, in the presence of "Queen Mothers" (FSW organizers), or in the presence of a FSW that has already been fingerprinted.
  
  
  CONCLUSIONS
  Our findings have major implications for key population research and improved health services provision. However, more work needs to be done to increase the acceptability of the electronic fingerprint-linked data capture system during field recruitment. This study indicated several potential avenues that will be explored to increase acceptability.
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, GA, USA. kmwall@emory.edu.|Rwanda Zambia HIV Research Group, Department of Pathology and Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, CNR 4011, Atlanta, GA, 30322, USA. kmwall@emory.edu.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Wall
authors.affiliation: Rwanda Zambia HIV Research Group, Department of Pathology and Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Lusaka, Zambia. wkilembe@rzhrg-mail.org.
authors.forename: William
authors.initials: W
authors.lastname: Kilembe
authors.affiliation: Rwanda Zambia HIV Research Group, Department of Pathology and Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Ndola, Zambia. minambao@rzhrg-mail.org.
authors.forename: Mubiana
authors.initials: M
authors.lastname: Inambao
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, GA, USA. yi.no.chen@emory.edu.
authors.forename: Yi No
authors.initials: YN
authors.lastname: Chen
authors.affiliation: Rwanda Zambia HIV Research Group, Department of Pathology and Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Lusaka, Zambia. mchoongo@rzhrg-mail.org.
authors.forename: Mwaka
authors.initials: M
authors.lastname: Mchoongo
authors.affiliation: Rwanda Zambia HIV Research Group, Department of Pathology and Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Ndola, Zambia. lkimaru@rzhrg-mail.org.
authors.forename: Linda
authors.initials: L
authors.lastname: Kimaru
authors.affiliation: Rwanda Zambia HIV Research Group, Department of Pathology and Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Lusaka, Zambia. yhammond@rzhrg-mail.org.
authors.forename: Yuna Tiffany
authors.initials: YT
authors.lastname: Hammond
authors.affiliation: Rwanda Zambia HIV Research Group, Department of Pathology and Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Lusaka, Zambia. tsharkey@rzhrg-mail.org.
authors.forename: Tyronza
authors.initials: T
authors.lastname: Sharkey
authors.affiliation: Rwanda Zambia HIV Research Group, Department of Pathology and Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Ndola, Zambia. kmalama@rzhrg-mail.org.
authors.forename: Kalonde
authors.initials: K
authors.lastname: Malama
authors.affiliation: Rwanda Zambia HIV Research Group, Department of Pathology and Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, CNR 4011, Atlanta, GA, 30322, USA. roice.fulton@gmail.com.|Gavi, the Vaccine Alliance, Geneva, Switzerland. roice.fulton@gmail.com.
authors.forename: T Roice
authors.initials: TR
authors.lastname: Fulton
authors.affiliation: Rwanda Zambia HIV Research Group, Department of Pathology and Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, CNR 4011, Atlanta, GA, 30322, USA. aat775@gmail.com.
authors.forename: Alex
authors.initials: A
authors.lastname: Tran
authors.affiliation: Rwanda Zambia HIV Research Group, Department of Pathology and Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Lusaka, Zambia. hhalumamba@rzhrg-mail.org.
authors.forename: Hanzunga
authors.initials: H
authors.lastname: Halumamba
authors.affiliation: Rwanda Zambia HIV Research Group, Department of Pathology and Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Lusaka, Zambia. sarah.anderson.ki@gmail.com.|Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. sarah.anderson.ki@gmail.com.
authors.forename: Sarah
authors.initials: S
authors.lastname: Anderson
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, GA, USA. nishant.kishore@emory.edu.
authors.forename: Nishant
authors.initials: N
authors.lastname: Kishore
authors.affiliation: Biometrac, Washington, DC, USA. shawn.sarwar@biometrac.com.
authors.forename: Shawn
authors.initials: S
authors.lastname: Sarwar
authors.affiliation: Biometrac, Louisville, KY, USA. trisha.finnegan@biometrac.com.
authors.forename: Trisha
authors.initials: T
authors.lastname: Finnegan
authors.affiliation: International AIDS Vaccine Initiative, New York, NY, USA. dmark@iavi.org.
authors.forename: David
authors.initials: D
authors.lastname: Mark
authors.affiliation: Rwanda Zambia HIV Research Group, Department of Pathology and Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, CNR 4011, Atlanta, GA, 30322, USA. sallen5@emory.edu.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Allen
mesh_terms: D001331:Automation; D056667:Biometric Identification / Q000295:instrumentation; D003625:Data Collection / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections; D006801:Humans; D018570:Risk Assessment; D060386:Sex Workers; D015024:Zambia