Evidence map›Paper›PMID 37185639›Full record

ArticleBMJ open2023

Implementing SARS-CoV-2 antigen testing scale-up in Rwanda: retrospective analysis of national programme data and qualitative findings.

Robert Rutayisire, Caroline E Boeke, Jessica Joseph, Namita Bansal, Noella Bigirimana, Owen Demke, Ashley Kallarakal, Prosper Karame, Rodrigue Ndayishimiye, Esperance Umumararungu and 2 more

Abstract read
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Robert Rutayisire *National Reference Laboratory, Rwanda Biomedical Center, Kigali, Rwanda.
Caroline E Boeke *Clinton Health Access Initiative, Boston, Massachusetts, USA caroline.boeke@mail.harvard.edu.ORCID 0000-0003-1939-1307
Jessica JosephClinton Health Access Initiative, Boston, Massachusetts, USA.ORCID 0000-0002-3860-4673
Namita BansalClinton Health Access Initiative, Boston, Massachusetts, USA.
Noella BigirimanaRwanda Biomedical Center, Kigali, Rwanda.
Owen DemkeClinton Health Access Initiative, Boston, Massachusetts, USA.
Ashley KallarakalClinton Health Access Initiative, Boston, Massachusetts, USA.
Prosper KarameResearch, Innovation and Data Science, Rwanda Biomedical Center, Kigali, Rwanda.
Rodrigue NdayishimiyeClinton Health Access Initiative, Kigali, Rwanda.
Esperance UmumararunguNational Reference Laboratory, Rwanda Biomedical Center, Kigali, Rwanda.
Trevor PeterClinton Health Access Initiative, Boston, Massachusetts, USA.
Shaukat KhanClinton Health Access Initiative, Boston, Massachusetts, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesReverse transcriptase PCR is the most sensitive test for SARS-CoV-2 diagnosis. However, the scale-up of these tests in low-income and middle-income countries (LMICs) has been limited due to infrastructure and cost. Antigen rapid diagnostic tests are an alternative option for diagnosing active infection that may allow for faster, easier, less expensive and more widespread testing. We compared the implementation of antigen and PCR testing programmes in Rwanda.

designWe retrospectively reviewed routinely collected PCR and antigen testing data for all reported tests conducted nationally. We administered semiquantitative surveys to healthcare workers (HCWs) involved in COVID-19 testing and care and clients receiving antigen testing.

settingRwanda, November 2020-July 2021.

participantsNational SARS-CoV-2 testing data; 49 HCWs involved in COVID-19 testing and care; 145 clients receiving antigen testing.

interventionsNone (retrospective analysis of programme data). PRIMARY AND SECONDARY OUTCOME MEASURES: Test volumes, turnaround times, feasibility and acceptability of antigen testing.

resultsData from 906 204 antigen tests and 445 235 PCR tests were included. Antigen testing increased test availability and case identification compared with PCR and had a median results return time of 0 days (IQR: 0-0). In contrast, PCR testing time ranged from 1 to 18 days depending on the sample collection site/district. Both HCWs and clients indicated that antigen testing was feasible and acceptable. Some HCWs identified stockouts and limited healthcare staff as challenges.

conclusionsAntigen testing facilitated rapid expansion and decentralisation of SARS-CoV-2 testing across lower tier facilities in Rwanda, contributed to increased case identification, reduced test processing times, and was determined to be feasible and acceptable to clients and providers. Antigen testing will be an essential component of SARS-CoV-2 test and treat programmes in LMICs.

Indexed as

COVID-19SARS-CoV-2COVID-19 Serological TestingCOVID-19 TestingHumansRetrospective StudiesRwandaCOVID-19Molecular diagnosticsPublic health

Identifiers

PMID37185639
PMCPMC10151244

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.