Application of the research electronic data capture (REDCap) system in a low- and middle income country- experiences, lessons, and challenges.

The challenges of reliably collecting, storing, organizing, and analyzing research data are critical in low- and middle-income countries (LMICs), particularly in Sub-Saharan Africa where several healthcare and biomedical research organizations have limited data infrastructure. The Research Electronic Data Capture (REDCap) System has been widely used by many institutions and hospitals in the USA for data collection, entry, and management and could help solve this problem. This study reports on the experiences, challenges, and lessons learned from establishing and applying REDCap for a large US-Nigeria research partnership that includes two sites in Nigeria, (the College of Medicine of the University of Lagos (CMUL) and Jos University Teaching Hospital (JUTH)) and Northwestern University (NU) in Chicago, Illinois in the United States. The largest challenges to this implementation were significant technical obstacles: the lack of REDCap-trained personnel, transient electrical power supply, and slow/intermittent internet connectivity. However, asynchronous communication and on-site hands-on collaboration between the Nigerian sites and NU led to the successful installation and configuration of REDCap to meet the needs of the Nigerian sites. An example of one lesson learned is the use of Virtual Private Network (VPN) as a solution to poor internet connectivity at one of the sites, and its adoption is underway at the other. Virtual Private Servers (VPS) or shared online hosting were also evaluated and offer alternative solutions. Installing and using REDCap in LMIC institutions for research data management is feasible; however, planning for trained personnel and addressing electrical and internet infrastructural requirements are essential to optimize its use. Building this fundamental research capacity within LMICs across Africa could substantially enhance the potential for more cross-institutional and cross-country collaboration in future research endeavors.

Effect of health education on the knowledge and attitude to sickle cell disorder and screening practices among school of nursing students in Sokoto, Nigeria.

BACKGROUND: Sickle cell disorder is the most important genetic hematological disease that affects people of black African descent. The years of young adulthood present a good opportunity for screening and counseling for this genetic blood disorder. OBJECTIVES: To assess effect of health education and provision of free sickle cell haemoglobin screening on knowledge of sickle cell disorder, attitude towards sickle cell haemoglobin screening, and uptake of sickle cell haemoglobin screening among students of a School of Nursing. METHODS: Study design was a quasi-experimental noncontrolled study. Self-administered questionnaire was used for pre- and post-intervention data collection. Implemented interventions were seminar on sickle cell disorder combined with free sickle cell haemoglobin screening. The data was analyzed with Epi-info version 3.5.1 statistical software package. RESULTS: Respondents who participated in all the study phases were 104. Mean knowledge score (%) was high (80.9 +/- 22.8%) at baseline and improved significantly to 91.8 +/- 9.4% (p < 0.001) at post intervention. 91.3% were willing to screen fiancée before getting married while 72.1% were willing not to go ahead with marriage if self and fiancée are carriers of sickle cell haemoglobin. Phenotype of the respondents that volunteered to be screened for sickle cell haemoglobin were: A (70.5%), AC (6.8%) and AS (22.7%). CONCLUSIONS: Implemented interventions, seminar on sickle cell disorder combined with free sickle cell haemoglobin screening service yielded significant impact on respondents' knowledge, attitude and uptake of sickle cell haemoglobin screening.

Ferritin and haematological values in healthy elderly Nigerians.

Two-hundred Nigerians (65 years and above) were studied and compared with control (18-50 years). Haematocrit, haemoglobin, mean corpuscular haemoglobin concentration, mean corpuscular haemoglobin, mean corpuscular volume, platelets and ferritin were analyzed. Mean ferritin levels were 105 ± 30 µg/L and 72 ± 10 µg/L (males and females respectively). Mean MCV, MCH and MCHC were 94.6 ± 9.0 fl, 93.6 ± 9.0 fl, 31.5 ± 3.0 pg, 31.4 ± 4.4 pg, 348 ± 30 g/L, and 347 ± 42 g/L. Mean haematocrits were 37 ± 4%, 36 ± 4%, while mean haemoglobins levels were 132 ± 24 g/L and 129 ± 1 g/L. RBC counts were 4.1 ± 0.8 x 1012/L, and 4.0 ± 0.5 x 1012/L. Mean total WBC counts were 6.4 ± 1.5 x 109/L and 6.3 ± 0.7 x 109/L; mean platelets were 170 ± 60 x 109/L, 184 ± 5 x 109/L. All haematological parameters were similar in both aged males and females, except ferritin, haematocrit, RBC and haemoglobin, which were significantly higher in males (p< 0.05). Significant sex differences exist in all the parameters, of control except MCV and total WBC count. There were significant differences in all the haematological parameters between the controls and the aged (p< 0.05), and between the aged (65-84 years) and the very aged (85-105 years) (p< 0.05). Reference haematological range needs to be established for the elderly Nigerians.