Data Management in Multicountry Consortium Studies: The Enterics For Global Health (EFGH) Shigella Surveillance Study Example.

Background: Rigorous data management systems and planning are essential to successful research projects, especially for large, multicountry consortium studies involving partnerships across multiple institutions. Here we describe the development and implementation of data management systems and procedures for the Enterics For Global Health (EFGH) Shigella surveillance study-a 7-country diarrhea surveillance study that will conduct facility-based surveillance concurrent with population-based enumeration and a health care utilization survey to estimate the incidence of Shigella--associated diarrhea in children 6 to 35 months old. Methods: The goals of EFGH data management are to utilize the knowledge and experience of consortium members to collect high-quality data and ensure equity in access and decision-making. During the planning phase before study initiation, a working group of representatives from each EFGH country site, the coordination team, and other partners met regularly to develop the data management systems for the study. Results: This resulted in the Data Management Plan, which included selecting REDCap and SurveyCTO as the primary database systems. Consequently, we laid out procedures for data processing and storage, study monitoring and reporting, data quality control and assurance activities, and data access. The data management system and associated real-time visualizations allow for rapid data cleaning activities and progress monitoring and will enable quicker time to analysis. Conclusions: Experiences from this study will contribute toward enriching the sparse landscape of data management methods publications and serve as a case study for future studies seeking to collect and manage data consistently and rigorously while maintaining equitable access to and control of data.

Complementary feeding may pose a risk of simultaneous exposures to aflatoxin M1 and deoxynivalenol in Indian infants and toddlers: Lessons from a mini-survey of food samples obtained from Kolkata, India.

A mini-survey of 29 different foods produced by 21 different Indian manufacturers was conducted for the presence of aflatoxins B1, B2, G1 and G2, aflatoxin M1 and deoxynivalenol. The products were purchased from local markets in Kolkata, India and commonly used in the complementary feeding of infants and toddlers in India. Using a previously established direct competitive enzyme-linked immunoassay for this analysis we show that 100% of the samples contained aflatoxin M1 at levels exceeding the recommended European Union levels of 25 ng kg-1 by more than an order of magnitude. Also, several (66%) of them contained detectable concentrations of deoxynivalenol with two samples (6.9%) exceeding European Union guidelines for baby food products (200 µg kg-1) and 51.7% samples with DON levels that can lead to dietary intake higher than 1  µg kg-1 recommended by the joint FAO/WHO expert committee on food additives. None of the samples contained aflatoxins B1, B2, G1 and G2. The results, therefore, suggest that complementary feeding can put Indian infants and toddlers at risk of simultaneous exposures to deoxynivalenol and aflatoxin M1 and warrant an urgent in-depth research to track, increase surveillance and reduce mycotoxin contamination of baby foods manufactured in India.