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.

Autor:	Nshimiyimana L; Rwanda Biomedical Centre, Kigali, Rwanda ladislas.nshimiyimana@rbc.gov.rw ladi8n@gmail.com., Bigirimana N; Rwanda Biomedical Centre, Kigali, Rwanda., Ngabonziza JS; Rwanda Biomedical Centre, Kigali, Rwanda.; University of Rwanda, Kigali, Rwanda., Rwabihama JP; Republic of Rwanda Ministry of Health, Kigali, Rwanda., Rutayisire R; Rwanda Biomedical Centre, Kigali, Rwanda., Semakula M; Republic of Rwanda Ministry of Health, Kigali, Rwanda., Rukundo G; Rwanda Biomedical Centre, Kigali, Rwanda., Mugabo H; Research Innovation and Data science, Rwanda Biomedical Centre, Kigali, Rwanda., Mutabazi J; Independent Consultant, Kigali, Rwanda., Mukamana B; Rwanda Biomedical Centre, Kigali, Rwanda., Mazarati JB; FIND, Geneva, Switzerland., Kadam R; FIND, Geneva, Switzerland., Akinwusi O; FIND, Geneva, Switzerland., Suleiman K; FIND, Geneva, Switzerland., Muvunyi CM; Rwanda Biomedical Centre, Kigali, Rwanda.; University of Rwanda, Kigali, Rwanda., Akugizibwe P; FIND, Geneva, Switzerland.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Oct 01; Vol. 14 (10), pp. e083410. Date of Electronic Publication: 2024 Oct 01.
DOI:	10.1136/bmjopen-2023-083410
Abstrakt:	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. Competing Interests: Competing interests: The authors J-BM, OA, KS, PA and RK disclose that they are employed by FIND. The other authors declare that no conflicts of interest exist. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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