Tailoring Mobile Data Collection for Intervention Research in a Challenging Context: Development and Implementation in the Malakit Study (Preprint)

BACKGROUND An interventional study named Malakit was implemented between 2018 and 2020 to address malaria on gold mining areas in French Guiana, in collaboration with Suriname and Brazil. This innovative intervention relied on the distribution of kits for self-diagnosis and self-treatment to gold miners after training by health mediators, named “facilitators” in the project. OBJECTIVE This paper aims to describe the process by which the information system was designed, developed and implemented to achieve the monitoring and evaluation of the Malakit intervention. METHODS The intervention was implemented in challenging conditions in five cross-border distribution sites which imposed strong logistical constraints for the design of the information system: isolation in the Amazon forest, tropical climate, lack of reliable electricity supply and Internet connection. Additional constraints originated from the interaction of the multicultural players involved in the study. The Malakit information system was developed as a patchwork of existing open-source, commercial services and tools developed in-house. Facilitators collected data from participants using Android tablets with ODK Collect, and sent encrypted form records to Ona when Internet was available. A custom R package (MalakitR) and a dashboard web app were developed to retrieve, decrypt, aggregate, monitor and clean data according to the feedback of facilitators and supervision visits on the field. RESULTS Between April 2018 and March 2020, nine facilitators generated a total of 4,863 form records, corresponding to an average of 202 records per month. Facilitators’ feedback was essential to adapt and improve mobile data collection and monitoring. Few technical issues were reported. The median duration of data capture was five minutes, suggesting that EDC was not overtaking time from participants, and it decreased over the course of the study as facilitators become more experienced. The quality of data collected by facilitators was satisfactory with only 3% of form records requiring correction. CONCLUSIONS The development of the information system for the Malakit project was a source of innovation that mirrored the inventiveness of the intervention itself. Our experience confirms that, even in a challenging environment, it is possible to produce good quality data and evaluate a complex health intervention by carefully adapting tools to field constraints and health mediators’ experience. CLINICALTRIAL ClinicalTrials.gov NCT03695770