Majam Mohammed, Msolomba Vanessa, Venter François, Scott Lesley Erica, Kahamba Trish, Stevens Wendy Susan, Rademeyer Michael, van Tonder Tanya, Karim Sanjida, Kadam Rigveda, Akugizibwe Paula
Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa.
Department of Molecular Medicine and Haematology, University of the Witwatersrand, Johannesburg 2193, South Africa.
Diagnostics (Basel). 2022 Feb 3;12(2):402. doi: 10.3390/diagnostics12020402.
Digital tools can support community-based decentralized testing initiatives to broaden access to COVID-19 diagnosis, especially in high-transmission settings. This operational study investigated the use of antigen-detecting rapid diagnostic tests (Ag-RDTs) for COVID-19 combined with an end-to-end digital health solution, in three taxi ranks in Johannesburg, South Africa. Members of the public were eligible if they were aged ≥18 years, could read, and had a cellphone. Over 15,000 participants, enrolled between June and September 2021, were screened for COVID-19 risk factors. A digital risk questionnaire identified 2061 (13%) participants as moderate risk and 2987 (19%) as high risk, based on symptoms and/or recent exposure to a known case. Of this group referred for testing, 3997 (79%) received Ag-RDTs, with positivity rates of 5.1% in the "high-risk" group and 0.8% in the "moderate-risk" group. A subset of 569 randomly selected participants received additional PCR testing. Sensitivity of the Ag-RDT in this setting was 40% (95% CI: 30.3%, 50.3%); most false negatives had high cycle threshold values (>25), hence low viral loads. Over 80% of participants who tested positive completed a 2-week phone-based follow-up questionnaire. Overall, the digital tool combined with Ag-RDTs enhanced community-based decentralized COVID-19 testing service delivery, reporting and follow-up.
数字工具可以支持基于社区的分散式检测举措,以扩大获得新冠病毒诊断的机会,特别是在高传播环境中。这项操作性研究在南非约翰内斯堡的三个出租车停靠站,调查了将新冠病毒抗原检测快速诊断测试(Ag-RDT)与端到端数字健康解决方案相结合的使用情况。如果公众年龄≥18岁、能识字且有手机,则符合参与条件。在2021年6月至9月期间登记的超过15000名参与者接受了新冠病毒风险因素筛查。一份数字风险问卷根据症状和/或近期接触已知病例情况,确定2061名(13%)参与者为中度风险,2987名(19%)为高风险。在被转诊进行检测的这组人群中,3997名(79%)接受了Ag-RDT检测,“高风险”组的阳性率为5.1%,“中度风险”组为0.8%。569名随机选择的参与者子集接受了额外的聚合酶链反应(PCR)检测。在这种情况下,Ag-RDT的敏感性为40%(95%置信区间:30.3%,50.3%);大多数假阴性结果的循环阈值较高(>25),因此病毒载量较低。超过80%检测呈阳性的参与者完成了一份为期2周的基于电话的随访问卷。总体而言,数字工具与Ag-RDT相结合增强了基于社区的分散式新冠病毒检测服务的提供、报告和随访。
Diagnostics (Basel). 2022-2-3
Cochrane Database Syst Rev. 2022-7-22