Quality Assurance and Quality Control in the Global Trachoma Mapping Project.

Anthony W Solomon,Allen Foster,Jeremiah Ngondi,Philip Downs,Ana Bakhtiari,Alexandre L Pavluck,Khumbo Kalua,Rebecca Willis,Caleb Mpyet,Uwazoeke Onyebuchi,Michael Dejene,Oumer Shafi,Sarah Bovill,Amir Bedri Kello,Oliver Sokana,Sheila K West,Siobhain Mccullagh,Danny Haddad,Paul Courtright,Boubacar Sarr,Wondu Alemayehu,Biruck Kebede,Tom Millar,Nicholas Olobio,Benjamin Chukwuemeka Nwobi ,Rebecca Flueckiger ,Colin Macleod ,Pamela J Hooper ,Brian Chu ,Lisa Rotondo

doi:10.4269/ajtmh.18-0082

Abstract

.In collaboration with the health ministries that we serve and other partners, we set out to complete the multiple-country Global Trachoma Mapping Project. To maximize the accuracy and reliability of its outputs, we needed in-built, practical mechanisms for quality assurance and quality control. This article describes how those mechanisms were created and deployed. Using expert opinion, computer simulation, working groups, field trials, progressively accumulated in-project experience, and external evaluations, we developed 1) criteria for where and where not to undertake population-based prevalence surveys for trachoma; 2) three iterations of a standardized training and certification system for field teams; 3) a customized Android phone–based data collection app; 4) comprehensive support systems; and 5) a secure end-to-end pipeline for data upload, storage, cleaning by objective data managers, analysis, health ministry review and approval, and online display. We are now supporting peer-reviewed publication. Our experience shows that it is possible to quality control and quality assure prevalence surveys in such a way as to maximize comparability of prevalence estimates between countries and permit high-speed, high-fidelity data processing and storage, while protecting the interests of health ministries.

Highlights

Trachoma is the leading infectious cause of blindness.[1]
A phased approach was used, initially mapping a small number of evaluation units (EUs) in which the likelihood of trachoma being a public health problem was felt to be the greatest, on the basis that mapping might be extended if prevalence was found to be high and not extended if it was not
In the spirit of full disclosure, it lists quality assurance and quality control measures that we did not take, either because doing so would have been too expensive or impractical or because the prompt to do so came with experience. Some measures in the latter category have been introduced for baseline, impact, and surveillance trachoma prevalence surveys supported by Tropical Data,[13,14] following the end of the Global Trachoma Mapping Project (GTMP)

Summary

INTRODUCTION

Trachoma is the leading infectious cause of blindness.[1]. To help direct global elimination of trachoma as a public health problem by 2020,2 the Global Trachoma Mapping Project (GTMP) aimed to complete the baseline trachoma map worldwide.[3]. A phased approach was used, initially mapping a small number of EUs in which the likelihood of trachoma being a public health problem was felt to be the greatest, on the basis that mapping might be extended if prevalence was found to be high and not extended if it was not. In the spirit of full disclosure, it lists quality assurance and quality control measures that we did not take, either because doing so would have been too expensive or impractical or because the prompt to do so came with experience Some measures in the latter category have been introduced for baseline, impact, and surveillance trachoma prevalence surveys supported by Tropical Data (www.tropicaldata.org),[13,14] following the end of the GTMP

METHODS

Systematically discussed

Initiated contact with health

RESULTS

DISCUSSION