Dataset Information

Point-of-contact interactive record linkage (PIRL) between demographic surveillance and health facility data in rural Tanzania.

ABSTRACT: Introduction:Health and demographic surveillance systems (HDSS) have been an invaluable resource for monitoring the health status of populations, but often contain self-reported health service utilisation, which are subject to reporting bias. Objective:To implement point-of-contact interactive record linkage (PIRL) between demographic and health facility systems data, characterise attributes associated with (un)successful record linkage, and compare findings with a fully automated retrospective linkage approach. Methods:Individuals visiting the Kisesa Health Centre were matched to their HDSS records during a short up-take interview in the waiting area of the health facility. The search algorithm was used to rank potential matches, from which the true match(es) were selected after consultation with the patient. Multivariable logistic regression models were used to identify characteristics associated with being matched to an HDSS record. Records matched based on respondent's clarifications were subsequently used as the gold-standard to evaluate fully automated retrospective record linkage by calculating sensitivity and positive predictive value (PPV). Results:Among 2,624 individuals who reportedly lived in the HDSS coverage area, we matched 2,206 (84.1%) to their HDSS records. Characteristics associated with a higher odds of being matched were increased age (OR 1.07, 95% CI 1.02, 1.12; per 5-year increment), a later consent into the study (OR 2.07, 95% CI 1.37, 3.12; in the most recent six-month period), and fieldworker level of experience. The main drivers of the linkage algorithm were name, sex, year of birth, village, sub-village, and household member name. At the lowest match score threshold, automated retrospective linkage would have only correctly identified and linked 55% (1440/2612) of the records with a PPV of 55% (1440/2612). Conclusion:Where resources are available, PIRL is a viable approach to link HDSS and other administrative data sources that outperforms purely retrospective approaches.

SUBMITTER: Rentsch CT

PROVIDER: S-EPMC6314455 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Point-of-contact interactive record linkage (PIRL) between demographic surveillance and health facility data in rural Tanzania.

Rentsch Christopher T CT Reniers Georges G Kabudula Chodziwadziwa C Machemba Richard R Mtenga Baltazar B Harron Katie K Mee Paul P Michael Denna D Natalis Redempta R Urassa Mark M Todd Jim J Zaba Basia B

International journal of population data science 20170901 1

<h4>Introduction</h4>Health and demographic surveillance systems (HDSS) have been an invaluable resource for monitoring the health status of populations, but often contain self-reported health service utilisation, which are subject to reporting bias.<h4>Objective</h4>To implement point-of-contact interactive record linkage (PIRL) between demographic and health facility systems data, characterise attributes associated with (un)successful record linkage, and compare findings with a fully automated ...[more]

PMID: 30613799

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Project description:IntroductionHealth and Demographic Surveillance Systems (HDSS) are important sources of population health data in sub-Saharan Africa, but the recording of pregnancies, pregnancy outcomes, and early mortality is often incomplete.ObjectiveThis study assessed HDSS pregnancy reporting completeness and identified predictors of unreported pregnancies that likely ended in adverse outcomes.MethodsThe analysis utilized individually-linked HDSS and antenatal care (ANC) data from Siaya, Kenya for pregnancies in 2018-2020. We cross-checked ANC records with HDSS pregnancy registrations and outcomes. Pregnancies observed in the ANC that were missing reports in the HDSS despite a data collection round following the expected delivery date were identified as likely adverse outcomes, and we investigated the characteristics of such individuals. Clinical data were used to investigate the timing of HDSS pregnancy registration relative to care seeking and gestational age, and examine misclassification of miscarriages and stillbirths.ResultsFrom an analytical sample of 2,475 pregnancies observed in the ANC registers, 46% had pregnancy registrations in the HDSS, and 89% had retrospectively reported pregnancy outcomes. 1% of registered pregnancies were missing outcomes, compared to 10% of those lacking registration. Registered pregnancies had higher rates of stillbirth and perinatal mortality than those lacking registration. In 77% of cases, women accessed ANC prior to registering the pregnancy in the HDSS. Half of reported miscarriages were misclassified stillbirths. We identified 141 unreported pregnancies that likely ended in adverse outcomes. Such cases were more common among those who visited ANC clinics during the first trimester, made fewer overall visits, were HIV-positive, and outside of formal union.ConclusionsRecord linkage with ANC clinics revealed pregnancy underreporting in HDSS, resulting in biased measurement of perinatal mortality. Integrating records of ANC usage into routine data collection can augment HDSS pregnancy surveillance and improve monitoring of adverse pregnancy outcomes and early mortality.

Project description:BackgroundHealth professionals and public health experts in maternal and newborn health encourage women to deliver at health facilities in an effort to reduce maternal and newborn mortality. In the existing literature, there is scant information on how migration, family members and community influence facility delivery. This study addresses this knowledge gap using 10 years of longitudinal surveillance data from a rural district of Tanzania.MethodsMultilevel logistic regression was used to quantify the influence of hypothesized migration, family and community-level factors on facility delivery while adjusting for known confounders identified in the literature. We report adjusted odds ratios (AOR).ResultsOverall, there has been an increase of 14% in facility delivery over the ten years, from 63% in 2001 to 77% in 2010 (p?<?.001). Women residing in households with female migrants from outside their community were more likely to give birth in a facility AOR?=?1.2 (95% CI 1.11-1.29). Furthermore, the previous facility delivery of sisters and sisters-in-law has a significant influence on women's facility delivery; AOR?=?1.29, 95% CI 1.15-1.45 and AOR?=?1.7, 95% CI 1.35-2.13 respectively. Community level characteristics play a role as well; women in communities with higher socioeconomic status and older women of reproductive age had increased odds of facility delivery; AOR?=?2.37, 95% CI 1.88-2.98 and AOR?=?1.17, 95% CI 1.03-1.32 respectively.ConclusionAlthough there has been an increase in facility delivery over the last decade in Rufiji, this study underscores the importance of female migrants, family members and community in influencing women's place of delivery. The findings of this study suggest that future interventions designed to increase facility delivery must integrate person-to-person facility delivery promotion, especially through women of the community and within families. Furthermore, the results suggest that investment in formal education of the community and increased community socio-economic status may increase facility delivery.

Project description:BACKGROUND:Linkage to care and treatment is an important part of efforts to accelerate HIV prevention, treatment, care, and support. It offers an opportunity for PLHIV to receive information and services in a timely manner. Clients who present late for HIV care and treatment may miss out on timely initiation of prophylaxis and ART, which may accelerate disease progression and lead to an increased rate of HIV transmission within the community. The objective of this study was to determine the factors influencing effective linkages of newly diagnosed PLHIV from the point of testing to entry in care and treatment centres (CTCs) in Tanga Region, Tanzania. METHODS:This cross-sectional study examined five clinics with a high volume of clients in each of the three districts in Tanga Region. All adults ages 18 years and above at the time of CTC enrolment, between 2010 and 2014, were eligible to participate in the study. The study engaged both secondary and primary data. To complement the secondary data, mixed methods were applied in primary data collection. Using a structured questionnaire, interviews with the sampled CTC clients while focus group discussions with healthcare providers and in-depth interviews with CTC clients. The qualitative data were analysed using a thematic analysis framework. The outcome of interest was whether a client enrolled in a CTC within three months of his or her first positive HIV test. A logistic regression model was used to determine factors associated with effective linkage of newly diagnosed HIV clients to CTC. RESULTS:A total of 16,041 adults from the three study districts were enrolled at a CTC from 2010 to 2014. A total of 1,096 clients from the sampled CTCs were recruited into the study for interview. The characteristics of these clients were representative of the larger group (16,041). The majority (72.4%) were female. More than half (52.1%) were married, and almost a quarter (21.2%) were single. The majority (59.6%) of participants completed primary education and almost half (45.1%) were subsistence farmers. The median CD4 count at enrolment was 218 (87-397) cells/mL with more than half (56.3%) having CD4 counts of less than 350 cells per millilitre (mL). Nearly all (91%) of the clients presented at a CTC within three months of receiving a positive HIV test. In a multivariate analysis, factors that remained significantly associated with early entry in CTC were level of education, CD4 count, and point of diagnosis. Participants' responses were consistent with many of the factors explained by participants to be barriers to effective linkages and referrals repeated in the FGDs and IDIs across the study sites. For instance, FGD respondent expressed that clients were worried about stigma from their relatives, which creates a delay in seeking treatment. CONCLUSION:Although the rate of early entry in care and treatment services is high, surprisingly was a marked increase in those who waited more than three months to seek treatment. To meet the target, issues such as disclosure and stigma need to be addressed.

Dataset Information

Point-of-contact interactive record linkage (PIRL) between demographic surveillance and health facility data in rural Tanzania.

Publications

Point-of-contact interactive record linkage (PIRL) between demographic surveillance and health facility data in rural Tanzania.

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