Seang Kennarey, Vogt Florian, Ky Sovathana, Ouk Vichea, Kaldor John, Vallely Andrew, Saphonn Vonthanak
Grant Management Office, University of Health Sciences, Phnom Penh, Cambodia.
The Kirby Institute, University of New South Wales, Sydney, Australia.
PLOS Glob Public Health. 2024 Feb 13;4(2):e0002940. doi: 10.1371/journal.pgph.0002940. eCollection 2024.
Several COVID-19 antigen rapid diagnostic tests have been approved in Cambodia, but no evidence exists about the access to and utilization of these tests. This limits public health interventions to increase testing, especially among vulnerable populations such as people living with HIV (PLWH). We conducted a mixed method study among PLWH in Phnom Penh, Cambodia, between July and August 2022 to understand their current Ag-RDT access and utilization levels, as well as key barriers and drivers. We undertook a cross-sectional survey and focus group discussions among 280 and 10 PLWH, respectively, from five HIV treatment centres using a probability-proportional-to-size and simple random sampling approach. Access was defined as having received a COVID-19 Ag-RDT within the six months and utilization as having administered a COVID-19 Ag-RDT, either to oneself or to others, within the 12 months prior to the study. We calculated means, standard deviations and proportions for continuous and categorical variables, using a linear regression model with random effects to account for clustering. Additionally, we fitted a logistic model with random effects to assess factors associated with Ag-RDT access. For the qualitative data, we used thematic analyses to identify barriers/enablers of Ag-RDT access and utilization. About 35% (n = 101) of PLWH reported having had access to an Ag-RDT test in the past six months. About 11% (n = 32) of the study participants administered the Ag-RDT to themselves, 4% (n = 10) to others and 9% (n = 24) have done both, in the past 12 months. Age and education appeared to be associated with Ag-RDT access in the logistic models. Price and advice from pharmacists were commonly reported to be the main selection criteria for the brand of Ag-RDT chosen. Ag-RDTs are an important diagnostic tool for COVID-19 among PLWH in Cambodia, but familiarity of use and price could hinder better uptake, access and utilization.
柬埔寨已批准了几种新冠病毒抗原快速诊断检测，但尚无关于这些检测的获取和使用情况的证据。这限制了旨在增加检测的公共卫生干预措施，尤其是在诸如艾滋病毒感染者等弱势群体中。2022年7月至8月期间，我们在柬埔寨金边的艾滋病毒感染者中开展了一项混合方法研究，以了解他们目前对抗原快速诊断检测的获取和使用水平，以及主要障碍和驱动因素。我们分别从五个艾滋病毒治疗中心，采用按规模大小成比例概率抽样和简单随机抽样方法，对280名和10名艾滋病毒感染者进行了横断面调查和焦点小组讨论。获取定义为在六个月内接受过新冠病毒抗原快速诊断检测，使用定义为在研究前12个月内给自己或他人进行过新冠病毒抗原快速诊断检测。我们计算了连续变量和分类变量的均值、标准差和比例，使用具有随机效应的线性回归模型来考虑聚类情况。此外，我们拟合了一个具有随机效应的逻辑模型，以评估与抗原快速诊断检测获取相关的因素。对于定性数据，我们使用主题分析来确定抗原快速诊断检测获取和使用的障碍/促进因素。约35%（n = 101）的艾滋病毒感染者报告在过去六个月内有机会接受抗原快速诊断检测。在过去12个月中，约11%（n = 32）的研究参与者给自己进行了抗原快速诊断检测，4%（n = 10）给他人进行了检测，9%（n = 24）两者都做过。在逻辑模型中，年龄和教育程度似乎与抗原快速诊断检测的获取有关。价格和药剂师的建议通常被报告为选择抗原快速诊断检测品牌的主要标准。抗原快速诊断检测是柬埔寨艾滋病毒感染者中诊断新冠病毒的重要工具，但使用的熟悉程度和价格可能会阻碍更好的接受、获取和使用。
