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RFP: Community-Based Applications of SARS-CoV-2 Antigen Rapid Diagnostic Tests (Ag RDTs) for Timely and Effective Public Health Response

Testing for SARS-CoV-2 infection is essential for the control of COVID-19, enabling epidemiological surveillance and implementation of public health measures. At the community level, swift identification and isolation of new cases, combined with contact tracing, are important tools for controlling virus transmission.

In December 2021, FIND’s Global Health Security (GHS) Operational Research (OR) team commissioned 17 community-based SARS-CoV-2 testing approaches in low-and middle-income countries (LMICs). The selection process was highly competitive as it became widely recognized among public health specialists that a health center-based approach was insufficient with regards to reducing SARS-CoV-2 transmission within communities. The proposals selected all demonstrated a clear community-based strategy for using SARS-CoV-2 antigen diagnostic tests for a timely and effective public health response.

The studies commissioned took place in 13 countries: Uganda, Malawi, Zimbabwe, Jamaica, Cameroon, Zambia, Kenya, Thailand, Suriname, Mozambique, South Africa, Mali, and Tanzania. More information on the outcomes of these research studies will be available in 2023. 

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RFP: Innovations in COVID-19 Antigen RDT Rollout in Underserved Populations

Searching for innovative ways to implement screening programmes for SARS-CoV-2 in underserved communities,  the ACT-Accelerator, FIND and IRD Global issued this request for proposals in May 2021.

The focus of the programmes was low- and middle-income countries. Globally stark inequities exist, with these countries not having adequate access to diagnostics during the COVID-19 pandemic.

The Access to COVID-19 Tools (ACT) Accelerator is a global collaboration focused on accelerating the development, production, and equitable access to COVID-19 tests, treatments, and vaccines. 

FIND is a global non-profit organization focusing on diagnostics for major diseases, and IRD Global is a global health delivery and research organization.

The project was projected to involve customizing training materials, conducting training and proficiency assessment of trainees, and implementing and monitoring testing programmes within local policies and guidelines. 

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Monitored Implementation of COVID-19 Rapid Antigen Screening at Taxi Ranks in Johannesburg, South Africa

The COVID-19 pandemic has accelerated the adoption of many innovations, including digital solutions to support access to diagnostics. These digital tools can be used by countries to expand support community-based testing and lessen the need to travel distances to clinical settings by moving testing meet patients where they are. 

This operational research study examines the utility of rapid diagnostics tests (RDTs) for COVID-19 detection in combination with an end-to-end digital health solution.This study took place between June and September 2021 at three local taxi ranks  in Johannesburg, South Africa. Over 15,000 members of the public were screened for COVID-19 risk factors via a digital questionnaire. Overall, the usage of the digital tool combined with RDTs were shown to improve decentralized service delivery, results reporting, and follow-up of COVID-19 testing at the community level. 

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WHO Public Health Labs Webinar – Accelerating community access to SARS-CoV-2 testing

In this webinar, co-hosted by WHO and FIND, speakers discussed efforts undertaken through the Access to COVID-19 Tools (ACT)-Accelerator to enable countries to improve their community-based testing for SARS-CoV-2 through the development of testing protocols and training of health-care workers, with experience sharing from Somalia and Zimbabwe.

Participants also discussed the newly published interim guidance on Use of SARS-CoV-2 antigen-detection rapid diagnostic tests for COVID-19 self-testing.

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Featured Work - Awareness & Advocacy

FIND and Unitaid invest US$2 million to support advocacy for COVID-19 test-and-treat approaches in low- and middle-income countries

FIND, the global alliance for diagnostics and Unitaid are investing US$2 million in a coordinated advocacy programme spanning 19 low- and middle-income countries (LMICs) designed to boost access and uptake of COVID-19 tests and treatments. A total of 21 organizations with a diverse range of healthcare expertise have been selected from more than 300 applicants, following a request for proposals (RFP) and competitive selection process that included assessment by a panel of independent reviewers. Criteria for funding included previous public health advocacy experience and expected impact of test-and-treat advocacy in the targeted region.

Projects range in duration from 6 to 18 months, and will raise awareness of COVID-19 testing and treatment among the public, key opinion leaders, and specific high-risk and vulnerable groups. Partners include (listed alphabetically by country): Mhair Educational, Health and Human Rights Organization (Afghanistan), Family Planning Association of Bangladesh (Bangladesh), IMAG Communication (Burkina Faso), Maison des Associations de lutte contre le Sida (Burkina Faso), Health Poverty Action Cambodia (Cambodia), Caritas Développement Mbujimayi (Democratic Republic of the Congo), TB Alert India (India), Pi Consulting (India), Kenya AIDS NGOs Consortium (Kenya), Health Poverty Action Laos (Laos), Caritas Lesotho (Lesotho), ESTAMOS (Mozambique), REDTRANS (Nicaragua), Shifa Foundation (Pakistan), Media for Deaf Rwanda (Rwanda), South Sudan Community Change Agency (South Sudan), Sikika (Tanzania), Université Mahmoud El Materi (Tunisia), HEPS (Uganda), Zambia Interfaith Working Group (Zambia), Pan-African Treatment Access Movement (Zimbabwe).

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Featured Work - Scaling Up & Sustainability

COVID-19 Ag RDT training package for community healthcare workers

The SARS-CoV-2 antigen rapid diagnostic test community health worker (SARS-CoV-2 Ag RDT CHW) training package is a structured, comprehensive collection of training resources and tools.

It aims to support institutions to organize, run and evaluate training of trainers and/or training of CHWs who will be performing SARS-CoV-2 testing using Ag RDTs.

The package can be used in face-to-face training or as a blend of remote face-to-face training. Materials can be adapted and customized based on national guidelines and participant target groups.

Training addresses the theoretical and practical components of SARS-CoV-2 Ag RDT testing and provides CHW trainees with the skills for, and resources on, how to safely perform SARS-CoV-2 Ag RDT tests. It does not intend to address the implementation of Ag RDT testing across the diagnostic network.

The materials for the training package are freely available to download, with links to material for facilitators provided in the document.

Access training package here

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Nairobi’s boda-boda riders take part in COVID-19 study

This discussion brief for a FIND and Jomo Kenyatta University of Agriculture and Technology (JKUAT) dissemination meeting on May 2021 focused on the riders of bicycles and motorcycle taxis, commonly known as boda bodas, in Nairobi, Kenya.

The operational research study used digital solutions, in conjunction with Ag-RDTs, to support decentralized COVID-19 and TB testing and linkage to healthcare of the subjects. 

It aimed to:

  • Create demand for testing among boda-boda riders.
  • Identify potential cases of COVID-19 and TB using a digital screening tool and link them to testing and care.
  • Measure COVID-19 and TB positivity rates among boda-boda riders.
  • Evaluate the performance of the Ag-RDT against RT-PCR.
  • Assess the effectiveness of the digital tool for comprehensive data capture.

The study was implemented jointly by JKUAT and MoH, in four counties: Machakos, Kiambu, Nairobi and Kajiado. 

The Boda-Boda Safety Association of Kenya (BAK) played an indispensable role in demand creation, and digital messaging was also used for sensitization. 

A total of 5,663 boda-boda riders enrolled in the study, all of whom received a general medical check that included measuring blood pressure and blood sugar.

There was high demand for community-based testing services not only among riders, but also from passers-by.

Following digital screening for COVID-19 and TB symptoms, 4,946 participants were selected for COVID-19 testing, with 372 of these also tested for TB .

Significant findings

Notable findings include:

  • A high prevalence of non-communicable diseases, and a relatively low national health insurance coverage, with 42% of riders having elevated blood pressure, and 48% abnormal blood sugar.
  • An overall COVID-19 positivity rate of 1% was found among those tested with Ag-RDTs. Of the participants who also received a PCR test, the overall positivity rate was 5%. There were differences between the four counties.
  • Of those tested for TB, no cases of COVID-19 and TB co-infections were found. However, more than half the participants reported respiratory symptoms.

What are the recommendations?

  • There is strong interest in, and uptake of, diagnostic services at community level, which could be leveraged to expand access to testing.
  • Integration of COVID-19 screening with screening for other respiratory diseases, such as TB, can optimize the value of community-based testing.
  • Boda-boda riders should be a priority group for health interventions.
  • Digital solutions can enhance delivery of decentralized diagnosis.

Read full report here

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Add Resources - Research & Development

Assessing COVID-19 digital tools in Kenya

This case study of Machakos and Mombasa counties in Kenya was conducted by the Ministry of Health, Jomo Kenyatta University of Agriculture and Technology, and FIND in 2021.

It mapped the use of digital tools to strengthen COVID-19 screening, testing, contact tracing and case management.

It makes findings on:

  • Management of COVID-19 in Machakos and Mombasa
  • COVID-19 management cascade
  • Use of digital tools
  • Primary and secondary outcomes
  • Epidemiological outcomes.

Key challenges are presented, and recommendations made on:

  • Screening process
  • Testing
  • Contact tracing
  • Management.

It also provides general recommendations to improve the use of digital tools for COVID-19 management in Kenya.

Read full report here