At completion of all study activities in the household, supervisors
uploaded data from the tablets (1) to a secure cloud server via a Wi-Fi or 3G
network connection using a pocket wireless router (2). CD4+ cell counts and
their associated participant identification number (PTIDs) were uploaded from
the CD4 PIMA analyzer via Wi-Fi or 3G network to a secure cloud server (3) and
subsequently merged with the survey database. Both satellite and central
laboratories used a Laboratory Data Management System (LDMS) (Frontier Science,
Boston, Massachusetts) database to track specimen receipt, processing, freezing
times, quantity, quality assurance testing data, storage location. and shipment
details which were transmitted to Frontier Science using encrypted flash drives
(4a, 4b) or directly (5). Central laboratory-based test results, including viral
load, early infant diagnosis, and HIV recency were either pulled directly from
the local laboratory information management system (LIMS) or sent in files
extracted from the test instruments and uploaded to a secure FTP server and
appended to the database (6, 7). Questionnaire data from the ODK server, CD4
data and LDMS quality assurance/quality control (QA/QC) data that went through
intermediary servers were all linked with the overall database (8, 9, 10). The
overall survey database was sent daily to an in-country server for local
stakeholders to access and monitor (11). After completion of data cleaning,
finalized data was also transferred to an in-country server (12).