Gambanga Fiona, Nchimunya Lindiwe, Makondesa Joseph, Chavula Chancy, Mulenga Namwaka, Mwenifumbo Tamara, Chitanda Francis, Mtaula Jonathan, Tsai Yucheng, Bitilinyu-Bangoh Joseph, Gunda Andrews, Shibemba Aaron, Choonga Powell, Khan Shaukat, Peter Trevor
Clinton Health Access Initiative, Boston, Massachusetts.
Ministry of Health, HTSS-Diagnostics, Lilongwe Central Region, Malawi.
Am J Trop Med Hyg. 2024 Oct 1;112(4_Suppl):63-70. doi: 10.4269/ajtmh.23-0785. Print 2025 Apr 1.
To expand access to testing beyond public health facilities and to strengthen surveillance efforts for COVID-19, community testing using COVID-19 antigen-based rapid diagnostic tests (Ag-RDTs) was identified as a major area of focus in Malawi and Zambia. This research aimed to gather evidence on the feasibility and acceptability of community testing in marketplaces. A cross-sectional study with a mixed-methods design was conducted in marketplaces in Malawi and Zambia to understand operational considerations for the implementation of Ag-RDTs for SARS-CoV-2 in a community setting. Programmatic data were collected prospectively as individuals were tested from June to September 2022. COVID-19 testing was done using Abbott Panbio nasal swab test kits. Semi-qualitative questionnaires were administered to individuals who tested, healthcare workers, and site-based personnel. Data were collected electronically via the SurveyCTO platform and analyzed using STATA. In Malawi, 2,348 participants were tested, and in Zambia, 1,723 people were tested for COVID-19. In Zambia, participants were 46% female, with a median age of 28 years, whereas in Malawi, participants were 69% female, with a median age of 37 years. In Malawi, 78 positive cases were reported (3.3% positivity rate), and in Zambia 10 positive cases were reported (0.5% positivity rate). In Zambia, 99% of 300 participants and in Malawi, 92% of 1,158 testers found the market testing experience and sample collection acceptable. Community testing is a feasible and acceptable intervention to increase testing access in Malawi and Zambia, especially when coupled with community awareness campaigns and mobilization.
为了扩大新冠病毒检测的覆盖范围，使其超出公共卫生设施范畴，并加强对新冠疫情的监测力度，使用基于新冠病毒抗原的快速诊断检测（Ag-RDTs）进行社区检测被确定为马拉维和赞比亚的一个主要重点领域。本研究旨在收集关于在市场中进行社区检测的可行性和可接受性的证据。在马拉维和赞比亚的市场中开展了一项采用混合方法设计的横断面研究，以了解在社区环境中实施针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的Ag-RDTs的操作考量因素。在2022年6月至9月对个体进行检测时前瞻性地收集了项目数据。使用雅培Panbio鼻拭子检测试剂盒进行新冠病毒检测。对接受检测的个体、医护人员和现场工作人员进行了半定性问卷调查。通过SurveyCTO平台以电子方式收集数据，并使用STATA进行分析。在马拉维，2348名参与者接受了检测，在赞比亚，1723人接受了新冠病毒检测。在赞比亚，参与者中46%为女性，中位年龄为28岁，而在马拉维，参与者中69%为女性，中位年龄为37岁。在马拉维，报告了78例阳性病例（阳性率为3.3%），在赞比亚，报告了10例阳性病例（阳性率为0.5%）。在赞比亚，300名参与者中有99%，在马拉维，1158名检测者中有92%认为市场检测体验和样本采集是可以接受的。社区检测是一种可行且可接受的干预措施，有助于在马拉维和赞比亚增加检测机会，特别是与社区宣传活动和动员相结合时。
