Implementation of an electronic fingerprint-linked data collection system: a feasibility and acceptability study among Zambian female sex workers

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.