This past week has been extremely busy for C3. (...well...for C2. Colby hasn’t really noticed any change to his little life of leisure.) We are in the midst of completing the cross-sectional survey that we have spent four months preparing for. This survey encompasses two projects: 1. Mass blood survey (mbs) for the Gates Project and 2. Test validation of a G6PD rapid diagnostic test. The mbs focuses on determining the prevalence of malaria in Wainyapu, while the G6PD test validation is evaluating the accuracy of a test designed to determine whether someone has a G6PD enzyme deficiency in the field (important information when deciding what drugs to prescribe to treat malaria infections). A team of people from the Eijkman Institute arrived from Jakarta and we headed to Wainyapu to collect blood. We set up in village offices, in churches, and in schools throughout the village. Some places had ample light, while others were dark homes for spiders.
People poured in to participate in the study or just stare at the strange scientists and their weird contraptions.
With any field study, there are many logistical and ethical considerations. Do we have enough batteries for the digital thermometers? What do we do if the lady who keeps the church key is at the market? Which wife can consent for which children when there is more than one wife? What about the man standing over our worktable with his large machete blowing smoke over our reagents and sensitive equipment?
Or what do we do when the person in front of us (or the parents) have no idea how old they are? I was constantly flabbergasted this week by the number of parents that had no clue how old their children were. The G6PD test we are validating has only been approved for persons 5 years and older. Given the limited education for the majority of villagers in Wainyapu (Maybe 1% of the villagers have completed school through highschool. I am not quite finished calculating this data – so this estimate is a guess.), it is difficult to explain why their child can’t participate in the full study. Not that full participation really mattered. Regardless of age, we screened for malaria infection and anyone currently infected was provided with treatment prescribed by a physician free of charge. The age cut-off only applied to the test validation.
I had one woman holding a toddler (2 years at best) on her lap telling me that he was most definitely 5 years old. What do you do? Is the child absurdly small for his age? Do you run the test anyways (since it will cause no harm to the child) or do you disregard the word of the mother and proceed cautiously?
As of today, we have enrolled nearly 800 people and we are hopeful that we will reach our target of 1000 by the end of the survey in a few days. Only 200 more people to convince that the pipetman in my hand is not for stabbing them!