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
| Title: | 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 |
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| Authors: | Claude Mambo Muvunyi, Rigveda Kadam, Muhammed Semakula, Ladislas Nshimiyimana, Jean-Paul Rwabihama, Beatrice Mukamana, Robert Rutayisire, Noella Bigirimana, Jean-Baptiste Mazarati, Gilbert Rukundo, Jean-Claude S Ngabonziza, Hassan Mugabo, Josue Mutabazi, Olukunle Akinwusi, Khairunisa Suleiman, Paula Akugizibwe |
| Source: | BMJ Open, Vol 14, Iss 10 (2024) |
| Publisher Information: | BMJ Publishing Group, 2024. |
| Publication Year: | 2024 |
| Collection: | LCC:Medicine |
| Subject Terms: | Medicine |
| More Details: | 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. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 2023-0834 2044-6055 |
| Relation: | https://bmjopen.bmj.com/content/14/10/e083410.full; https://doaj.org/toc/2044-6055 |
| DOI: | 10.1136/bmjopen-2023-083410 |
| Access URL: | https://doaj.org/article/4bff1a9b77644562bc4143a2d6f0286f |
| Accession Number: | edsdoj.4bff1a9b77644562bc4143a2d6f0286f |
| Database: | Directory of Open Access Journals |
| ISSN: | 20230834 20446055 |
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| DOI: | 10.1136/bmjopen-2023-083410 |
| Published in: | BMJ Open |
| Language: | English |