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     Across Asia, Africa, and the Americas, researchers strive to find ways to save lives and improve health. The work often takes place in some of the most impoverished and disease-threatened regions of the world, under less-than-optimal conditions.
     RTI is making that work easier by installing and maintaining sophisticated local computer networks at the research sites, linked securely to the Internet and augmented by an array of advanced data collection tools and technology. RTI's pool of multidisciplinary expertise is what makes such support possible, according to Gordon Cressman, director of Information and Communications Technology for RTI's International Development Group (IDG).

Staff supporting the community popular opinion leaders study in China attended a training workshop on project data collection procedures. [PHOTO: Lisa Strader]

     "We can leverage the skills of experts in survey research, computer data collection, and information technology, along with the country-specific knowledge of our international development staff," Cressman explained.
     As one example, RTI provides technical support for a clinical trial that examines whether consuming a special type of maize can help women in rural Guatemala to give birth to healthier infants. Study participants receive either this special maize or, as a control measure, a type of maize similar to what is normally consumed there. Nurses regularly visit the mothers and their infants in their homes to collect information on their nutritional health so that the effects of two maizes can be compared. These data are then keyed into a central computer and transmitted to RTI's main U.S. site, in North Carolina, for storage and analysis.
     In another example, RTI provides network support for a project involving some 40 hospitals scattered all around Latin America. Doctors in those hospitals use handheld computers to collect health information on newborns, which is then transferred to a central computer server in Buenos Aires, Argentina, and from there to RTI.
     These projects are just two of many being implemented through the Global Network for Women's and Children's Health, for which RTI serves as the data coordinating center. In this role RTI's responsibilities include setting up and maintaining the data collection system.
     RTI's experts have developed standardized data gathering, transmission, and networking systems--both the hardware and the software--that can be shipped anywhere a new health research project is starting up. Although nearly turn-key, the systems are individualized somewhat for each location, due to differences among countries in such things as Internet service reliability, maintenance availability, and import regulations on equipment.

This spread-spectrum wireless Internet connection was purchased and installed at a research center in Entebbe, Uganda, for transmitting C-POL project data. [PHOTO: Gordon Cressman]

     "We adapt ourselves to the country and use what's there," said David Palacios, Network Specialist, who travels to the various Global Network sites to help maintain and enhance the local systems. "We may use VSAT, cable, DSL, LDMS, or ISDN to connect to the Internet--whatever is available. We may buy equipment locally, or buy it in the U.S. and ship it, depending on which is more cost-effective." This is where RTI's extensive "local knowledge," built up over years of international work, is a strength, Palacios noted.
     RTI provides similar technical support to the National Institute of Mental Health (NIMH) as data coordinating center for the Collaborative HIV/STD Prevention Trial. This is the first international test of the theory that HIV/STD infection can be reduced by recruiting community popular opinion leaders--C-POLs in project shorthand--to encourage people to adopt less risky behaviors.
     For this project, RTI has set up local data networks in China, India, Russia, Zimbabwe, and Peru, and has trained field workers to recruit study participants and to survey them at intervals as to sexual practices and other behaviors. The surveys are conducted using state-of-the-art, computer-assisted personal interviewing--or CAPI--software developed at RTI.
     "Our CAPI system is truly amazing," said Lisa Strader, a research epidemiologist and RTI's project manager for C-POL. "The study conducts interviews in six languages:

Computer-assisted personal interviewing (CAPI) software, developed at RTI, is used to help researchers collect personal data from participants in health studies. For one HIV/AIDS-related study with sites throughout Asia and Africa, the software was programmed in six different languages. [PHOTO: John Theilgard]

Mandarin, Tamil, Spanish, Russian, Shona, and Ndebele. We use project site translators and a translation service to provide us the different language texts, and they're programmed into the software at our North Carolina offices," said Strader.
     C-POL participants also have blood and other biological samples taken as part of the study. The samples are tested in labs at the study sites and never leave the country where they are collected, but the data from them are sent via the Internet to RTI. At RTI the data are cleaned and analyzed, then sent on to NIMH's principal U.S.-based investigators for each of the C-POL sites.
     "Our role is to ensure that the data are collected, transmitted, and analyzed according to the study protocol," Strader said. "We also make site visits to ensure quality control. And, we're the archive for all information in the C-POL study."
     For all networking projects, seamless and automated data storage and transmission are critical, as is security. "We want those local servers be as fault-tolerant as possible," said Cressman. This means having redundant power supplies, firewalls, and so on.
     Digital certificates are used at the transmitting sites to encrypt and compress vital study data. When the data packets arrive at RTI, they are computer-checked for integrity and made available for further processing, with notification going out automatically to the appropriate data managers.
     "Systems like this, for collecting and quickly transmitting health-related information around the globe, will become increasingly critical in a world dealing not only with AIDS and similar long-standing health challenges, but also with emerging infectious diseases such as SARS," Cressman predicted.

More information:
Gordon Cressman, e-mail gmc@rti.org
David Palacios, e-mail dpalacios@rti.org
Lisa Strader, e-mail lcs@rti.org

Where in the World is RTI is a bimonthly publication of RTI's International Development Group (IDG). This publication is intended to inform clients and partner organizations about RTI's global activities and research areas. RTI is dedicated to improving the human condition in developing and emerging countries. RTI staff have conducted international project work for over 25 years in 120 countries around the world. We offer a broad range of policy support, applied research and analysis, and other technical expertise in strategic planning, institutional development, and training. Our expertise is multisectoral and spans the fields of education, health, environment and natural resources, governance, finance, and information and communication technology.