Using digital tools and antigen rapid testing to support household-level SARS-CoV-2 detection by community health...

Area of Science:

• Public Health
• Infectious Disease Control
• Health Informatics

Background:

• Rwanda aims to decentralize COVID-19 testing to improve accessibility.
• Community Health Workers (CHWs) are crucial for healthcare delivery in Rwanda.
• Integrating digital tools with rapid diagnostics can enhance public health interventions.

Purpose of the Study:

• To evaluate the use of antigen-based rapid diagnostic tests (Ag-RDTs) combined with a digital tool (e-ASCov) for household-level COVID-19 testing.
• To assess the operational feasibility and impact of this integrated approach delivered by CHWs.
• To align with Rwanda's strategy for decentralized COVID-19 testing.

Main Methods:

• An operational pilot study was conducted in eight districts across Rwanda.
• 800 CHWs were trained to use Ag-RDTs and the e-ASCov digital application for data capture.
• A subset of Ag-RDTs was repeated by laboratory technicians to assess result concordance.

Main Results:

• 19,544 individuals were screened; 86 (1.9%) tested positive via Ag-RDTs.
• 100% concordance was observed between CHW and laboratory technician Ag-RDT results.
• Over 93% of trained CHWs could independently conduct testing and data transmission, with >80% finding the tools easy to use.

Conclusions:

• The deployment of a digital tool and Ag-RDTs for household-level SARS-CoV-2 detection in Rwanda is feasible.
• Digitally supported rapid testing by CHWs can broaden access to testing for various priority diseases.
• This model supports Rwanda's goal of decentralized healthcare services.