Evidence map›Paper›PMID 39160102›Full record

ArticleBMJ open2024

Evaluating the gap in rapid diagnostic testing: insights from subnational Kenyan routine health data.

Bibian N Robert, Angela K Moturi, Felix Bahati, Peter M Macharia, Emelda A Okiro

Abstract read
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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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

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Bibian N Robert *Population & Health Impact Surveillance Group, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya brobert@kemri-wellcome.org.ORCID 0000-0002-9737-883X
Angela K Moturi *Population & Health Impact Surveillance Group, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.ORCID 0000-0002-9614-5786
Felix BahatiHealth Services Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
Peter M MachariaPopulation & Health Impact Surveillance Group, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.ORCID 0000-0003-3410-1881
Emelda A OkiroPopulation & Health Impact Surveillance Group, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.ORCID 0000-0001-9543-8360

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundUnderstanding diagnostic capacities is essential to addressing healthcare provision and inequity, particularly in low-income and middle-income countries. This study used routine data to assess trends in rapid diagnostic test (RDT) reporting, supplies and unmet needs across national and 47 subnational (county) levels in Kenya.

methodsWe extracted facility-level RDT data for 19 tests (2018-2020) from the Kenya District Health Information System, linked to 13 373 geocoded facilities. Data quality was assessed for reporting completeness (ratio of reports received against those expected), reporting patterns and outliers. Supply assessment covered 12 RDTs reported by at least 50% of the reporting facilities (n=5251), with missing values imputed considering reporting trends. Supply was computed by aggregating the number of tests reported per facility. Due to data limitations, demand was indirectly estimated using healthcare-seeking rates (HIV, malaria) and using population data for venereal disease research laboratory test (VDRL), with unmet need computed as the difference between supply and demand.

resultsReporting completeness was under 40% across all counties, with RDT-specific reporting ranging from 9.6% to 89.6%. Malaria RDTs showed the highest annual test volumes (6.3-8.0 million) while rheumatoid factor was the lowest (0.5-0.7 million). Demand for RDTs varied from 2.5 to 11.5 million tests, with unmet needs between 1.2 and 3.5 million. Notably, malaria testing and unmet needs were highest in Turkana County, as well as the western and coastal regions. HIV testing was concentrated in the western and central regions, with decreasing unmet needs from 2018 to 2020. VDRL testing showed high volumes and unmet needs in Nairobi and select counties, with minimal yearly variation.

conclusionRDTs are crucial in enhancing diagnostic accessibility, yet their utilisation varies significantly by region. These findings underscore the need for targeted interventions to close testing gaps and improve data reporting completeness. Addressing these disparities is vital for equitably enhancing diagnostic services nationwide.

Indexed as

Diagnostic Tests, RoutineHealth Services Needs and DemandHIV InfectionsHumansKenyaMalariaEPIDEMIOLOGYHealth Services AccessibilityPUBLIC HEALTH

Identifiers

PMID39160102
PMCPMC11337709

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LicenceCC BY
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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.