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Table 3 Concerns and recommendations around the use of biosensor machine

From: Glucose 6 Phosphate Dehydrogenase (G6PD) quantitation using biosensors at the point of first contact: a mixed method study in Cambodia

Items

Problems

Data

Pipette

Black line in pipette is hard to appreciate. Especially older VMWs had problem appreciating the black line

Pipettes are too small. When the pipette takes bubble, it can affect the result

Need to use two pipettes

R: Using two pipettes is difficult…..and take other new one for sample and put into machine I feel difficult and my hands were shaking because that hole is small, I have to be very careful and very concentrate to the hole, that is the difficulty. If possible, we use one pipette, it can be confusing when it looks same as the previous. SSI-15

I: If there is bubble inside and you still put into machine, for example. Do you think you get a good result or not?

R: No… teacher, if the amount [is] low or over, it will be [show an] error. SSI-14

Sample Processing

The sample processing steps require a prompt completion, letting the measurement chamber flap open for little longer, machine will display an error

R: Which aspects do you think it is easy to use for the biosensor? I: In total, its easy …..when we take the sample…[but]…ooh not easy sometime if sample taking is more or over, and the easy aspect is battery.….if the sample is enough the result [will] appear, and if the cap [remains] open for longer time it [result] will not appear, It is an error. And sometimes it [reading] came with difference that’s what I did not want. It’s error. I: yes. SSI-3

Test device

The hole within the test device is too small and sometimes mixture of buffer and blood were not able to be placed in it

I: What about one hole inside when you put the sample whether it gets to the side of that hole?

R: There was a little, but I did not clean because I am scared of [getting] it broken

I: Do you think it is too small?

R: It is too small, sometime the sample is poured out to the side of the hole

I: That’s why it showed the different result due to the sample which was not enough. SSI-10

Chip code

Insertion and removal of chip code is difficult. Removing chip code was difficult, some used knives to remove it and were scared that it could break

I: Ohm….I heard someone told me about its difficulty, oh… yes at XXX village…VMW, she tried to remove it with the end of the sharp knife but it did not come out, so she decided to keep it in there. SSI-15

I: Given you have used in the field setting, would you like to share with us, how the challenges you have identified can be avoided for future use?

R: It is hard to remove the chip code out after each test, I think it would be better [to leave it], I left it inside, no need to take out and batteries as well. SSI-10

Buffer tube

VMWs did not feel comfortable with buffer tube because there is nothing to support it, it can fall down any time by wind, or air from fan. It should have something to support; support for buffer tube so that it would be easy while processing

R: I don’t like it that it was made without stand to support, each time my children helped by standing nearby to hold it for me when I processed, because I was worried about [it] falling down. SSI-20

R: It should be harder than this [kit box], and the one we are using today it is easy to tear because we cannot finish tests in a month. I like buffer but I don’t like that it doesn’t have the support, for me I asked my husband to drill a small piece of wood with a hole to stand the buffer tube when I process the G6PD for patients. SSI-21

R: No matter with me, but if it can be made any plastic with hole to support the buffer avoiding somehow falling down while we process the sample, that would be great. I made myself [one] from wood with drilling a hole to support the buffer. SSI-13

Device package box

The device package box is made from paper and thus can absorb water and is vulnerable to easy damage

I: What do you think about packing of the box, and test?

R: I also want the box to be updated to harder or [made] from plastic, mine already broken because I travelled to forest, if I am not going to forest no matter with it. SSI-30

I: What about the box of test?

R: It is a kind of paper easy to get damaged, if it can be the plastic, it would be great so that it won’t absorb water,… Sometimes when I am visiting patient’s house and rain falls it will get wet, who knows? SSI-15

Battery

There is no notification about battery and VMWs could not identify the status of the battery. Electricity-chargeable battery would have been great

I: What do you not like about the biosensor?

R: There was nothing that I did not like it, it does not have any weak points, and its easy to use, only the battery that we cannot know the [status of] power remaining or not. SSI-32