tetano
Editor, Senior Moderator
BMJ Open
. 2024 Oct 1;14(10):e083410.
doi: 10.1136/bmjopen-2023-083410. Using digital tools and antigen rapid testing to support household-level SARS-CoV-2 detection by community health workers in Rwanda: an operational pilot study
Ladislas Nshimiyimana[SUP] 1 [/SUP], Noella Bigirimana[SUP] 2 [/SUP], Jean-Claude S Ngabonziza[SUP] 2 3 [/SUP], Jean-Paul Rwabihama[SUP] 4 [/SUP], Robert Rutayisire[SUP] 2 [/SUP], Muhammed Semakula[SUP] 4 [/SUP], Gilbert Rukundo[SUP] 2 [/SUP], Hassan Mugabo[SUP] 5 [/SUP], Josue Mutabazi[SUP] 6 [/SUP], Beatrice Mukamana[SUP] 2 [/SUP], Jean-Baptiste Mazarati[SUP] 7 [/SUP], Rigveda Kadam[SUP] 7 [/SUP], Olukunle Akinwusi[SUP] 7 [/SUP], Khairunisa Suleiman[SUP] 7 [/SUP], Claude Mambo Muvunyi[SUP] 2 3 [/SUP], Paula Akugizibwe[SUP] 7 [/SUP]
Affiliations
Objective: To evaluate the use of antigen-based rapid diagnostic tests (Ag-RDTs) alongside a digital tool to deliver household-level COVID-19 testing by community health workers (CHWs), in line with Rwanda's ambition to decentralise COVID-19 testing.
Design: This was an operational pilot study to evaluate the impact and operational characteristics of using the digital e-ASCov tool combined with Ag-RDTs to support COVID-19 symptom screening and rapid testing by CHWs across eight districts in Rwanda. A total of 800 CHWs selected from both rural and urban areas were trained in delivering Ag-RDTs for COVID-19 testing and using the e-ASCOV application for data capture on a smartphone. Laboratory technicians repeated a subset of Ag-RDTs to assess the concordance of results obtained by CHWs. The study also assessed CHWs' experience of the intervention using a mixed-methods approach.
Setting: Eight rural, urban and semiurban districts in Rwanda.
Participants: A total of 19 544 individuals were enrolled and screened for signs and symptoms of COVID-19.
Interventions: Community-based screening for COVID-19 by CHWs using the digital tool e-ASCov combined with rapid testing using Ag-RDTs.
Main outcome measures: Number of participants screened and tested; concordance of Ag-RDT results between CHWs and laboratory technicians; feasibility of study procedures by CHWs and CHWs perceptions of the digital tool and Ag-RDT testing.
Results: From February to May 2022, CHWs screened 19 544 participants, of whom 4575 (23.4%) had COVID-19-related symptoms or a history of exposure to the infection. Among them, 86 (1.9%) were positive on Ag-RDTs. Concordance of Ag-RDT results between CHWs and laboratory technicians was 100%. Of the 800 trained CHWs, 746 (93.3%) were independently able to conduct household-based COVID-19 screening, perform the Ag-RDTs and send data to the central server. Most CHWs (>80%) found Ag-RDTs and e-ASCOV easy to use.
Conclusions: This study demonstrated the feasibility of deploying a digital tool and Ag-RDTs for household-level SARS-CoV-2 detection in Rwanda. The findings support a broader roll-out of digitally supported rapid testing by CHWs to broaden access to testing for priority diseases.
Keywords: COVID-19; health services; public health.
. 2024 Oct 1;14(10):e083410.
doi: 10.1136/bmjopen-2023-083410. Using digital tools and antigen rapid testing to support household-level SARS-CoV-2 detection by community health workers in Rwanda: an operational pilot study
Ladislas Nshimiyimana[SUP] 1 [/SUP], Noella Bigirimana[SUP] 2 [/SUP], Jean-Claude S Ngabonziza[SUP] 2 3 [/SUP], Jean-Paul Rwabihama[SUP] 4 [/SUP], Robert Rutayisire[SUP] 2 [/SUP], Muhammed Semakula[SUP] 4 [/SUP], Gilbert Rukundo[SUP] 2 [/SUP], Hassan Mugabo[SUP] 5 [/SUP], Josue Mutabazi[SUP] 6 [/SUP], Beatrice Mukamana[SUP] 2 [/SUP], Jean-Baptiste Mazarati[SUP] 7 [/SUP], Rigveda Kadam[SUP] 7 [/SUP], Olukunle Akinwusi[SUP] 7 [/SUP], Khairunisa Suleiman[SUP] 7 [/SUP], Claude Mambo Muvunyi[SUP] 2 3 [/SUP], Paula Akugizibwe[SUP] 7 [/SUP]
Affiliations
- PMID: 39353691
- DOI: 10.1136/bmjopen-2023-083410
Objective: To evaluate the use of antigen-based rapid diagnostic tests (Ag-RDTs) alongside a digital tool to deliver household-level COVID-19 testing by community health workers (CHWs), in line with Rwanda's ambition to decentralise COVID-19 testing.
Design: This was an operational pilot study to evaluate the impact and operational characteristics of using the digital e-ASCov tool combined with Ag-RDTs to support COVID-19 symptom screening and rapid testing by CHWs across eight districts in Rwanda. A total of 800 CHWs selected from both rural and urban areas were trained in delivering Ag-RDTs for COVID-19 testing and using the e-ASCOV application for data capture on a smartphone. Laboratory technicians repeated a subset of Ag-RDTs to assess the concordance of results obtained by CHWs. The study also assessed CHWs' experience of the intervention using a mixed-methods approach.
Setting: Eight rural, urban and semiurban districts in Rwanda.
Participants: A total of 19 544 individuals were enrolled and screened for signs and symptoms of COVID-19.
Interventions: Community-based screening for COVID-19 by CHWs using the digital tool e-ASCov combined with rapid testing using Ag-RDTs.
Main outcome measures: Number of participants screened and tested; concordance of Ag-RDT results between CHWs and laboratory technicians; feasibility of study procedures by CHWs and CHWs perceptions of the digital tool and Ag-RDT testing.
Results: From February to May 2022, CHWs screened 19 544 participants, of whom 4575 (23.4%) had COVID-19-related symptoms or a history of exposure to the infection. Among them, 86 (1.9%) were positive on Ag-RDTs. Concordance of Ag-RDT results between CHWs and laboratory technicians was 100%. Of the 800 trained CHWs, 746 (93.3%) were independently able to conduct household-based COVID-19 screening, perform the Ag-RDTs and send data to the central server. Most CHWs (>80%) found Ag-RDTs and e-ASCOV easy to use.
Conclusions: This study demonstrated the feasibility of deploying a digital tool and Ag-RDTs for household-level SARS-CoV-2 detection in Rwanda. The findings support a broader roll-out of digitally supported rapid testing by CHWs to broaden access to testing for priority diseases.
Keywords: COVID-19; health services; public health.