Kenya: HIV and Aids Research Shifts to New Technology


Two research institutions have adopted a technological solution to maximise efficiency in data collection in HIV and Aids research.

The Questionnaire Development System (QDS), which the Kenya Medical Research Institute (Kemri) and the Centre for Disease Control (CDC) have adopted, is a digital solution that would be used to increase reliability of data collected during research.

Kemri uses the system in cases where respondents are required to divulge sensitive information about themselves.

So far, the technology has been used on more than 2,000 respondents in Nyanza and the western Kenya. The two institutions expect the new technology to help them forecast the annual incidence of HIV infection among adolescents and adults in Kisumu.

"We are currently employing the QDS in our Nyanza HIV and Aids cohort study because we have found that there was a need to improve the data collection used," says Beatrice Okong'o, an administrative assistant at Kemri/CDC.

This type of study usually is used in medicine, social sciences, actuarial science, and ecology. It involves observation and analysis of risk factors among a group of people who are not infected with the disease.

In the HIV/ and Aids cohort study, a panel of respondents were selected and their HIV status monitored over a period of time. Change or maintenance of their status compared their behaviour.

"In order to get this data, what used to happen in the past is that respondents were issued with questionnaires and a research assistant would ask open and closed ended questions for each session", says Ms Okong'o. "This method was found to be prone to errors as many respondents were nervous to discuss personal information like sexual trends."

She added that some of the respondents would give answers that were "appropriate" leading to a distortion of the findings.

This prompted Kemri and CDC to seek an alternative and a less intrusive method to collect sensitive data.

The new systems have been used in more developed countries as a method of data collection. The current model used by the researchers was first used in the continent by South Africa before being adopted by Kenya.

"Basically, the QDS system is a software application that digitises the paper questionnaire that would ordinarily be self-administered or researcher-administered to the respondent", says Monica Nyambura, a HIV research cohort data analyst. "Computer assisted structured interviews (CASI) refers to interviews where the humans are replaced by a digital element (usually a computer), which conducts the interview and records data."

Using an audio-CASI, the research subject listens to a recorded human voice or a text-to-speech synthesized voice and responds to the question via keyboard entry or the use of another input device such as a touch screen or mouse.

The QDS software used at the institution employs a mix of audio and visual format to digitally collect and record the data. It is composed of a simple laptop with a touchscreen interface, headphones and a biometric fingerprint reader.

The biometric finger print reader provides the only form of identification and respondents are given numbers in order to ensure anonymity and boost their confidence.

The respondent is ushered into a secluded room where he/she sits in front of the computer for an interview. During the session, questions and responses are displayed on the screen for participants to choose.

The questions and choices are read out to the respondent through head phones, which are connected to the computer.

When the respondent sees the question on the screen and listens to it through the headphones, he/she is required to give their answer by touching the computer screen where the response is displayed. "Studies have shown that computer administered data collection formats like the QDS and Audio-CASI reduce inhibitions respondents may have when they are asked to report intimate risk behaviours by research assistants," says Ms Nyambura.

In addition to this, the accuracy of the information revealed by a respondent is positively related to the level of privacy of the interview.

"This has proved true in our HIV and Aids studies, especially when we deal with teenagers who do not feel free to discuss information like the number of partners they have slept with or whether or not they used protection," said Margaret Atieno, an administrative assistant at Kemri/CDC.

The system is also expected to boost handling of information collected.

"The QDS is not only helpful in the data collection but also in its processing and storage. Since the data is digitally collected, recording and coding is eased and errors reduced", says Monica.