Performance of a rapid antigen test for SARS-CoV-2 in Kenya

Onsongo, Simon; Otieno, Kephas; Duijn, Shannen van; Adams, Emily; Omollo, M.; Odero, Isdorah; K’Oloo, Alloys; Houben, Nathalie; Milimo, Emmanuel; Aroka, R.; Barsosio, Hellen C.; Oluoch, F.; Odhiambo, Albert; Kariuki, Simon; Wit, Tobias F. Rinke de

doi:10.1016/j.diagmicrobio.2021.115591

Cited by 16 publications

(12 citation statements)

References 27 publications

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“…The COVID-Dx dashboard indicated geographic areas in LREB of insufficient access to PCR (molecular)-based SARS-CoV-2 testing. This initiated a rapid field evaluation of alternative rapid diagnostic tests (RDT) for usage at the point-of-care (62), resulting in a first Kenyan publication in this field. Recent analysis on immunocompromised patients indicated that the proportion of such patients among COVID-19+ was significantly 3 times higher than among the COVID-19-individuals (P < 0.001).…”

Section: Covid-dxmentioning

confidence: 99%

Digital health systems strengthening in Africa for rapid response to COVID-19

Wit

Janssens

Antwi³

et al. 2022

Front.Health Serv.

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The COVID-19 pandemic has painfully exposed the constraints of fragile health systems in low- and middle-income countries, where global containment measures largely set by high-income countries resulted in disproportionate collateral damage. In Africa, a shift is urgently needed from emergency response to structural health systems strengthening efforts, which requires coordinated interventions to increase access, efficiency, quality, transparency, equity, and flexibility of health services. We postulate that rapid digitalization of health interventions is a key way forward to increase resilience of African health systems to epidemic challenges. In this paper we describe how PharmAccess' ongoing digital health system interventions in Africa were rapidly customized to respond to COVID-19. We describe how we developed: a COVID-19 App for healthcare providers used by more than 1,000 healthcare facilities in 15 African countries from May–November 2020; digital loans to support private healthcare providers with USD 20 million disbursed to healthcare facilities impacted by COVID-19 in Kenya; a customized Dutch mobile COVID-19 triage App with 4,500 users in Ghana; digital diaries to track COVID-19 impacts on household expenditures and healthcare utilization; a public-private partnership for real-time assessment of COVID-19 diagnostics in West-Kenya; and an expanded mobile phone-based maternal and child-care bundle to include COVID-19 adapted services. We also discuss the challenges we faced, the lessons learned, the impact of these interventions on the local healthcare system, and the implications of our findings for policy-making. Digital interventions bring efficiency due to their flexibility and timeliness, allowing co-creation, targeting, and rapid policy decisions through bottom-up approaches. COVID-19 digital innovations allowed for cross-pollinating the interests of patients, providers, payers, and policy-makers in challenging times, showing how such approaches can pave the way to universal health coverage and resilient healthcare systems in Africa.

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Section: Covid-dxmentioning

confidence: 99%

Digital health systems strengthening in Africa for rapid response to COVID-19

Wit

Janssens

Antwi³

et al. 2022

Front.Health Serv.

Self Cite

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“…The capacity for PCR-based COVID-19 testing has heavily leveraged existing laboratory capacity. In many countries this has been limited only to major cities where laboratories are situated [ 44 , 45 , 86 ]. This is of concern in LMIC malaria-endemic countries where up to 80% of the population can live in rural and remote communities [ 23 ] resulting in a lack of widespread access to COVID-19 testing in these nations [ 46 ].…”

Section: Rdts For Improved Detection Of Covid-19 In Rural and Remote ...mentioning

confidence: 99%

Lessons for improved COVID-19 surveillance from the scale-up of malaria testing strategies

Kerr

Robinson

Russell

et al. 2022

Malar J

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Effective control of infectious diseases is facilitated by informed decisions that require accurate and timely diagnosis of disease. For malaria, improved access to malaria diagnostics has revolutionized malaria control and elimination programmes. However, for COVID-19, diagnosis currently remains largely centralized and puts many low- and middle-income countries (LMICs) at a disadvantage. Malaria and COVID-19 are infectious diseases that share overlapping symptoms. While the strategic responses to disease control for malaria and COVID-19 are dependent on the disease ecologies of each disease, the fundamental need for accurate and timely testing remains paramount to inform accurate responses. This review highlights how the roll-out of rapid diagnostic tests has been fundamental in the fight against malaria, primarily within the Asia Pacific and along the Greater Mekong Subregion. By learning from the successful elements of malaria control programmes, it is clear that improving access to point-of-care testing strategies for COVID-19 will provide a suitable framework for COVID-19 diagnosis in not only the Asia Pacific, but all malarious countries. In malaria-endemic countries, an integrated approach to point-of-care testing for COVID-19 and malaria would provide bi-directional benefits for COVID-19 and malaria control, particularly due to their paralleled likeness of symptoms, infection control strategies and at-risk individuals. This is especially important, as previous disease pandemics have disrupted malaria control infrastructure, resulting in malaria re-emergence and halting elimination progress. Understanding and combining strategies may help to both limit disruptions to malaria control and support COVID-19 control.

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“…However, for Ag-RDT to fulfill this purpose, it is essential to recognize the performance of different tests and the impact of disease duration and other variables on their accuracy in real-life studies in different world regions. Significant differences between the accuracy of Ag-RDT reported by the manufacturers and that observed under field conditions have already been reported [ 9 , 10 ]. Most of these studies evaluated hospitalized patients with severe forms of COVID-19 and in the first days of symptoms, conditions with a presumed high viral load in respiratory specimens, which possibly favors test performance [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Performance differences among commercially available antigen rapid tests for COVID-19 in Brazil

et al. 2022

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A rapid and accurate diagnosis is a crucial strategy for containing the coronavirus disease (COVID-19) pandemic. Considering the obstacles to upscaling the use of RT–qPCR, rapid tests based on antigen detection (Ag-RDT) have become an alternative to enhance mass testing, reducing the time for a prompt diagnosis and virus spreading. However, the performances of several commercially available Ag-RDTs have not yet been evaluated in several countries. Here, we evaluate the performance of eight Ag-RDTs available in Brazil to diagnose COVID-19. Patients admitted to tertiary hospitals with moderate or mild COVID-19 symptoms and presenting risk factors for severe disease were included. The tests were performed using a masked protocol, strictly following the manufacturer’s recommendations and were compared with RT–qPCR. The overall sensitivity of the tests ranged from 9.8 to 81.1%, and specificity greater than 83% was observed for all the evaluated tests. Overall, slight or fair agreement was observed between Ag-RDTs and RT–PCR, except for the Ag-RDT COVID-19 (Acro Biotech), in which moderate agreement was observed. Lower sensitivity of Ag-RDTs was observed for patients with cycle threshold > 25, indicating that the sensitivity was directly affected by viral load, whereas the effect of the disease duration was unclear. Despite the lower sensitivity of Ag-RDTs compared with RT–qPCR, its easy fulfillment and promptness still justify its use, even at hospital admission. However, the main advantage of Ag-RDTs seems to be the possibility of increasing access to the diagnosis of COVID-19 in patients with a high viral load, allowing immediate clinical management and reduction of infectivity and community transmission.

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Performance of a rapid antigen test for SARS-CoV-2 in Kenya

Cited by 16 publications

References 27 publications

Digital health systems strengthening in Africa for rapid response to COVID-19

Digital health systems strengthening in Africa for rapid response to COVID-19

Lessons for improved COVID-19 surveillance from the scale-up of malaria testing strategies

Performance differences among commercially available antigen rapid tests for COVID-19 in Brazil

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