Udoh Ekerette, Okonkwo Osayamen, Omoregie Godpower, Ura-Akubo Victoria, Anosike Nnamdi, Folorunsho Joshua, Orakwelu Evelyn, Bimba John, Hatzold Karin, Corbett Elizabeth L, Nightingale Emily, Dunkley Yasmin
Society for Family Health, Abuja, Nigeria.
Zankli Research Centre, Bingham University, Nasarawa, Nigeria.
PLoS One. 2024 Dec 10;19(12):e0310294. doi: 10.1371/journal.pone.0310294. eCollection 2024.
Decentralized COVID-19 testing with antigen rapid diagnostic tests (Ag-RDT) is recommended by the Nigerian Centre for Disease Control for community-level services. These services have been provided in Primary Healthcare Centers, Community Pharmacies, and licensed "Patent Medicine Stores" that serve the least affluent communities. To support quality assurance, we applied an adapted version of SPI-RT (Stepwise Process for Improving the Quality of HIV Rapid and Recency Testing) to sites providing COVID-19-RDTs in Federal Capital Territory of Nigeria.
Between September 2022 and February 2023 community healthcare facilities (48 Community Pharmacies, 21 Patent Medicine Stores, 79 Primary Health Centers) were evaluated using Stepwise Process for Improving the Quality of SARS-CoV-2 Antigen Rapid Diagnostic Testing (SPI-RT) Checklist, tailored to the local implementation context. Evaluated domains included service quality, documents and records, personnel training and certification, safety, physical infrastructure, pre-testing phase, testing phase, and post-testing phase. Each facility received an overall score, expressed as a percentage indicating their performance level.
41/79 (52%) of Primary Health Centers scored at least 90% for service quality, as did 19/48 (40%) of pharmacies, with only 1/21 (4.8%) Patent Medicine Store. Apart from personnel training and certification, Primary Health Centers scored highest across most domains of service quality, followed by Community Pharmacies. The lowest median score in any domain was in the Patent Medicine Stores on testing and safety at 60% for both post-testing phase and safety.
Primary Healthcare Centers and Community Pharmacies can provide quality decentralized testing for COVID-19. Patent Medicine Stores may need additional support including monitoring and quality improvement initiatives to ensure the provision of high-quality decentralized COVID-19 rapid testing services.
尼日利亚疾病控制中心建议在社区层面使用抗原快速诊断检测（Ag-RDT）进行分散式新冠病毒检测。这些检测服务已在基层医疗中心、社区药房以及为最贫困社区服务的有执照的“成药商店”中提供。为了确保质量，我们将SPI-RT（提高艾滋病毒快速检测和近期感染检测质量的逐步流程）的一个改编版本应用于尼日利亚联邦首都地区提供新冠病毒抗原快速检测的场所。
在2022年9月至2023年2月期间，使用针对当地实施情况量身定制的提高新冠病毒抗原快速诊断检测质量的逐步流程（SPI-RT）清单，对社区医疗机构（48家社区药房、21家成药商店、79家基层医疗中心）进行了评估。评估领域包括服务质量、文件和记录、人员培训与认证、安全、物理基础设施、检测前阶段、检测阶段和检测后阶段。每个机构都获得了一个总体分数，以百分比表示其表现水平。
79家基层医疗中心中有41家（52%）在服务质量方面得分至少达到90%，48家药房中有19家（40%）得分至少达到90%，而成药商店中只有1家（4.8%）得分至少达到90%。除人员培训与认证外，基层医疗中心在大多数服务质量领域得分最高，其次是社区药房。在任何领域中得分最低的中位数是成药商店在检测后阶段和安全方面的得分，均为60%。
基层医疗中心和社区药房可以提供高质量的新冠病毒分散式检测。成药商店可能需要额外的支持，包括监测和质量改进措施，以确保提供高质量的新冠病毒分散式快速检测服务。
