Direct data capture using hand-held computers in rural Burkina Faso: experiences, benefits and lessons learnt Peter Byass 1 , Sennen Hounton 2 , Moctar Oue ´ draogo 2 , Henri Some ´ 2 , Ibrahima Diallo 2 , Edward Fottrell 1 , Axel Emmelin 1 and Nicolas Meda 2 1 Immpact, University of Aberdeen, Aberdeen, UK 2 Immpact, Centre Muraz, Bobo-Dioulasso, Burkina Faso Summary objectives To assess our experiences of using hand-held computers (personal digital assistants, PDAs) for direct data capture in a large community-based geo-referenced survey in rural Burkina Faso, highlighting benefits and lessons learnt from their use. methods A population-based geo-referenced survey of over 500 000 people was undertaken using PDAs with in-built GPS receivers and the resulting database analysed in terms of successful completion, error rates and interview durations. results Surveys were successfully completed for 84 861 households (98.3%) by 127 interviewers. The data input error rate was assessed at 0.24%, with more than half of the errors being made by less than 10% of the interviewers. Faster interviewers were not less accurate. Time-stamped and geo-referenced data allowed reconstruction of particular interviewer-day activities. conclusions Although the survey setting was challenging, the feasibility of using direct data capture on a large scale was well established. We learnt that, with more experience, we could have made better use of real-time entry and quality control checking procedures. The work involved in designing and setting up a complex survey on PDAs prior to data collection should not be underestimated. keywords data capture, hand-held computers, personal digital assistants, geo-referencing, GPS, community survey, epidemiology Introduction Large-scale community surveys in developing countries are difficult and expensive, frequently requiring large teams of interviewers for house-to-house enquiries, considerable logistic support, and often long periods afterwards for data entry and cleaning. In many settings, established proce- dures for capturing, entering and controlling data quality (Rowan et al. 1987) have not changed markedly during the past 20 years, despite huge advances in information technology. Community surveys have typically involved capturing data on paper questionnaires at the household level and then using a nearby centre as a base for data entry and cleaning, but current technological advances and economic trends mean that hand-held computers or personal digital assistants (PDA) are fast becoming a viable alternative (Gupta 1996; Diero et al. 2006). Proponents would argue that direct data capture at the point of interview can reduce error rates and speed up the cleaning process, and hence make databases available for analysis sooner (Epihandy 2006; Menda 2007), and may prove more cost-effective in the longer term. Possible counter- arguments are that there may be considerable logistic difficulties in operating high-tech equipment reliably under difficult field conditions, and that the risks of losing an entire unit, together with the data it might be holding, could outweigh the advantages. However, in the literature we have been unable to find any substantial evidence of adverse experiences or disadvantages of using direct data capture in fieldwork, although there is some evidence from institutional settings (Shelby-James et al. 2007). Relatively few attempts have been made to carry out field data capture using different approaches as a comparative trial (Forster et al. 1991; Fletcher et al. 2003; Vivoda & Eby 2006), perhaps as this increases (apparently unnecessarily) the complexity of what may already be a difficult undertaking. Evidence on the use of PDAs in community-based surveys, particularly in Africa, is therefore sparse and often subjective. Even where non-comparative methods have been used, there is often very little analysis of parameters such as error rates, inter- and intra-observer variations and cost-effectiveness, so Tropical Medicine and International Health doi:10.1111/j.1365-3156.2008.02084.x volume 13 suppl. 1 pp 25–30 july 2008 ª 2008 The Authors Journal compilation ª 2008 Blackwell Publishing Ltd, 13 (Suppl. 1), 25–30 25