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Research Article

Feasibility and Acceptability of Severe Acute Respiratory Syndrome Coronavirus 2 Antigen Rapid Diagnostic Testing in High-Risk Markets and Trade Hubs in Kampala, Uganda

Isaac Ssewanyana Central Public Health Laboratory, Ministry of Health, Kampala, Uganda;

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Sam Acellam Central Public Health Laboratory, Ministry of Health, Kampala, Uganda;

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Martha Ampumuza Central Public Health Laboratory, Ministry of Health, Kampala, Uganda;

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Hellen Nansumba Central Public Health Laboratory, Ministry of Health, Kampala, Uganda;

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Susan Nabadda Central Public Health Laboratory, Ministry of Health, Kampala, Uganda;

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Grace Kushemererwa Central Public Health Laboratory, Ministry of Health, Kampala, Uganda;

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Victor Bigira Central Public Health Laboratory, Ministry of Health, Kampala, Uganda;

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Sarah Zalwango Kampala Capital City Authority, Kampala, Uganda;

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Chris Oundo Kampala Capital City Authority, Kampala, Uganda;

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Richard Walyomo Kampala Capital City Authority, Kampala, Uganda;

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Isaiah Chebrot Kampala Capital City Authority, Kampala, Uganda;

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Dennis Mike Buluma Kampala Capital City Authority, Kampala, Uganda;

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Alex Ndyabakira Kampala Capital City Authority, Kampala, Uganda;

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Pallavi Dani FIND, Geneva, Switzerland;

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Anne Hoppe FIND, Geneva, Switzerland;
Elizabeth Glaser Pediatric AIDS Foundation, Geneva, Switzerland

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DOI:
https://doi.org/10.4269/ajtmh.23-0899
Volume/Issue:
Ahead of Print
Open access
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Congregate settings are high-risk places for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, making strategies that rely solely on hospital-based testing ineffective in curbing transmissions. We therefore evaluated the feasibility, utility, and acceptability of testing with SARS-CoV-2 antigen rapid diagnostic tests (Ag-RDTs) in markets and trade hubs in Kampala, Uganda. Between June and September 2022, we conducted a prospective operational research study in five divisions of Kampala. Four rounds of monthly cross-sectional surveys were conducted at one market and one trading hub per division, resulting in a total of 13,086 volunteers tested. Females were more likely than males to be tested (54% versus 46%), which aligns with sex-based differences in health-seeking behavior. More tests were conducted in markets (68%) compared with trade centers (32%). Several interventions increased overall demand for testing, including 1) awareness campaigns and mobilization activities; 2) the movement of teams across congregate settings; 3) the optimization of workflow; and 4) testing traders at their workstations. The overall positivity rate during the 4 months was 0.6% (78/13,086). There was a steady decline in positivity rates by month, aligning with the trend observed at the national level. Of the 78 positive index cases identified, 105 contacts were traced; 71% of these could be reached. None of the positive patients successfully self-isolated for the 14 days specified in national guidelines. Nevertheless, this study demonstrates that testing market dwellers with Ag-RDTs is not only acceptable and feasible in Uganda but also an important public health tool for the timely detection of SARS-CoV-2. This approach may be replicated in similar settings.

Author Notes

Financial support: This project was supported by FIND through a grant that it received from the German Federal Ministry for Economic Cooperation and Development (BMZ).

Current contact information: Isaac Ssewanyana, Sam Acellam, Martha Ampumuza, Hellen Nansumba, Susan Nabadda, Grace Kushemererwa, and Victor Bigira, Central Public Health Laboratory, Ministry of Health, Kampala, Uganda, E-mails: sewyisaac@yahoo.co.uk, sacellam@gmail.com, ampumuzam@yahoo.com, hnansumba@gmail.com, sndidde@gmail.com, kushbblt@yahoo.com, and vbigira@gmail.com. Sarah Zalwango, Chris Oundo, Richard Walyomo, Isaiah Chebrot, Dennis Mike Buluma, and Alex Ndyabakira, Kampala Capital City Authority, Kampala, Uganda, E-mails: skzalwango@gmail.com, chrisoundo@gmail.com, rwalyomo@yahoo.com, ichebrot@kcca.go.ug, dbuluma@kcca.go.ug, and andyabakira@kcca.go.ug. Pallavi Dani, FIND, Geneva, Switzerland, E-mail: pallavi.dani@finddx.org. Anne Hoppe, Elizabeth Glaser Pediatric AIDS Foundation, Geneva, Switzerland, E-mail: ahoppe@pedaids.org.

Address correspondence to Isaac Ssewanyana, Central Public Health Laboratory (CPHL)/Uganda National Health Laboratory Services (UNHLS), Plot 1062, 106 Old Butabika Rd., Kampala, Uganda. E-mail: sewyisaac@yahoo.co.uk
Copyright:
© The author(s) 2025
Received:
30 Dec 2024
|
Accepted:
20 Nov 2024
|
Published Online:
25 Feb 2025
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645

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