Health workers’ Perspective on the Feasibility and Acceptability of the Introduction of AgRDT for COVID-19 in Kisumu County, Western Kenya

  1. M. Omollo
  2. I. A. Odero
  3. H.C. Barsosio
  4. S. Kariuki
  5. F. Ter Kuile
  6. S.O. Okello
  7. K. Oyoo
  8. A. K’Oloo
  9. K. Otieno
  10. S. van Duijn
  11. N. Houben
  12. E. Milimo
  13. R. Aroka
  14. A. Odhiambo
  15. S. N. Onsongo
  16. T.F. Rinke de Wit

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Abstract

COVID-19 pandemic remains a major global public health challenge also in Low- and Middle-Income Countries (LMIC), due to fragile health systems, limited resources and personnel, low testing and counseling capacity, community perceptions, among others. In Kisumu County of Western Kenya, a unique Public Private Partnership (PPP) was rolled-out to increase testing and capacity building by linking private facilities to the ongoing public sector efforts in combating COVID-19. It became increasingly clear that centralized PCR testing for COVID-19 was too labor-intensive, expensive, prone to machine breakdowns and stock-outs of essential reagents, resulting in long turn-around times and sometimes even adaptations of patient selection criteria. A clear need was identified for rapid point-of-care COVID-19 testing (AgRDT). After successful field evaluation, RDT for COVID-19 was offered through the PPP. This paper aimed to understand the health workers perspective on the feasibility and acceptability of the introduction of the AgRDT in Kisumu County.

In-Depth Interviews were conducted with selected health workers (n=23) from the participating facilities and analyzed using Nvivo 11 The health workers accepted the use of AgRDT as it enabled the strengthening of the existing health system, increased testing capacity and provided capacity building opportunities. Challenges included poor management of results discrepant with PCR gold standard.

The health workers applauded the introduction of AgRDT with the Kisumu County Department of Health as a more realistic and user-friendly approach, leading to fast turn-around times and increased personal safety experience.

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  1. ScreenIT

    SciScore for 10.1101/2022.05.24.22275498: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: Ethical approvals and consent to participate: The Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH): Institution and Ethical Review Committee provided research and ethical approval with license number IERC.
    IRB: Ethical approvals and consent to participate: The Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH): Institution and Ethical Review Committee provided research and ethical approval with license number IERC.
    Field Sample Permit: Additional research and ethical approval was provided by the National Commission for Science, Technology and Innovation (NACOSTI) with License Number ABS/P/20/7959.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There were two limitations that the health workers noted about the study. First, the study was designed as a pilot to the Kisumu County Department of Health, in which the usage of AgRDT was done alongside confirmatory PCR testing. Although participants were informed about the possibility of discrepant results, these did result in some confusion. It was found out that a major cause of the discrepancy was attributed to non-adherence by healthcare staff to the study procedures where sometimes one and the same nasal pharyngeal swab was used for both AgRDT and PCR testing. This could result in false-negativity, due to dilution of the sample (15). Secondly, the test-result communication channels were not always clear and changed during the project, involving 3 different partners in addition to the participating facilities. There were no formal DoH protocols on communication channels, and in some cases feedback was not relayed to patients in a timely manner causing frustration and anxiety (16).

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2022.05.24.22275498v1 on medRxiv