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A Cross-Sectional Study of the Use of Antigen Rapid Diagnostic Tests for Community Identification of Severe Acute Respiratory Syndrome Coronavirus-2 in Kenya
Rose Masaba
rmasaba@pedaids.org
Rose Masaba
Elizabeth Glaser Pediatric AIDS Foundation, Nairobi, Kenya;
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Stephen Siamba
Stephen Siamba
Elizabeth Glaser Pediatric AIDS Foundation, Nairobi, Kenya;
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Heather J. Hoffman
Heather J. Hoffman
The George Washington University, Washington, District of Columbia;
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Edyth Osire
Edyth Osire
Elizabeth Glaser Pediatric AIDS Foundation, Nairobi, Kenya;
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Njoki Kimani
Njoki Kimani
Kiambu County Government, Ministry of Health, Kiambu, Kenya;
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Magoma Kwasa
Magoma Kwasa
Kiambu County Government, Ministry of Health, Kiambu, Kenya;
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Mario Songane
Mario Songane
Elizabeth Glaser Pediatric AIDS Foundation, Maputo, Mozambique;
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Lise Denoeud-Ndam
Lise Denoeud-Ndam
Elizabeth Glaser Pediatric AIDS Foundation, Geneva, Switzerland
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Mass testing with antigen-detecting rapid diagnostic tests (Ag-RDT), including testing of asymptomatic individuals, is expected to improve the identification of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections. Mass testing was offered at large gatherings to determine the SARS-CoV-2 case detection rate and the acceptance and cost of implementing this community testing strategy. In 49 high-attendance venues in Kiambu County, Kenya, from June to September 2022, individuals 2 years and older were offered coronavirus disease 2019 (COVID-19) testing, vaccination, and participation in a survey. Polymerase chain reaction (PCR) testing and genome sequencing were conducted for those testing positive by Ag-RDT and those testing negative but with COVID-19 symptoms. Costs were collected from financial records, budgets, and invoices and estimated from a health systems perspective using a micro-costing method. A total of 4,062 individuals were offered testing. The testing acceptance was 3,174/4,062 (78.1%). The case detection rate was 34/3,174 (1.07%; 95% CI: 0.7–1.4%), and 11/34 (32%) of the positives were asymptomatic. The PCR results were available for 27 Ag-RDT‒positive participants and 14 Ag-RDT‒negative participants with SARS-CoV-2 symptoms and were positive in 24/27 (88.9%) and 4/14 (28.6%), respectively. Circulating variants were identified in 11 participants. Community mobilization was the major cost driver (26%) followed by purchase of SARS-CoV-2 Ag-RDTs (20.5%). The cost per individual tested was USD $15.89, and the cost per individual tested positive for SARS-CoV-2 was USD $1,484. The study demonstrates that SARS-CoV-2 Ag-RDTs could be used for identification of SARS-CoV-2 infections in both symptomatic and asymptomatic individuals at mass gatherings.
Author Notes
Financial support: This project was supported by FIND through a grant FIND received from the
Disclosures: Trial registration NCT05458557. The study was approved by the Amref Ethics and Scientific Review Committee (ESRC), approval number ESRC P1151-2022, dated April 13, 2022. Interviews were conducted after obtaining informed consent from those aged ≥18 years and mature minors and consent from parents and assent from children and adolescents for those aged 10–17 years. All data were kept confidential and only the study team had access to patient data.
Current contact information: Rose Masaba, Stephen Siamba, and Edyth Osire, Elizabeth Glaser Pediatric AIDS Foundation, Nairobi, Kenya, E-mails: rmasaba@pedaids.org, stephen.siamba@gmail.com, and edythatieno@gmail.com. Heather J. Hoffman, George Washington University, Washington, DC, E-mail: hhoffman@gwu.edu. Njoki Kimani, Kiambu County Emergency Operations Center, Kiambu, Kenya, E-mail: tnjoki.kimani@gmail.com. Magoma Kwasa, Kiambu County Health Research and Development Unit, Kiambu, Kenya, E-mail: mkwasa@live.com. Mario Songane, Elizabeth Glaser Pediatric AIDS Foundation, Maputo, Mozambique, E-mail: msongane@pedaids.org. Lise Denoeud-Ndam, Elizabeth Glaser Pediatric AIDS Foundation, Geneva, Switzerland, E-mail: ldenoeud@pedaids.org.
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