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Creating access to SARS-CoV-2 screening and testing through community-based COVID-19 case-finding, observations from cross-sectional studies in Lesotho and Zambia

BACKGROUND: The health impact of the COVID-19 pandemic largely depends on the ability of the healthcare systems to develop effective and adaptable preparedness and mitigation strategies. A collaborative initiative (BRCCH-EDCTP COVID-19 Initiative) was set up between Lesotho and Zambia early on in th...

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Autores principales: Klinkenberg, Eveline, Katende, Bulemba, Ruperez, Maria, Bresser, Moniek, Kangololo, Bxyn, Bwalya, Justin, Erhardt, Rahel M., Schaap, Ab, Kasese, Nkatya, Gatchie, Thomas, Floyd, Sian, ‘Mota, ‘Mota J., Ayles, Helen, Shanaube, Kwame, Reither, Klaus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10364377/
https://www.ncbi.nlm.nih.gov/pubmed/37488552
http://dx.doi.org/10.1186/s12889-023-16306-2
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author Klinkenberg, Eveline
Katende, Bulemba
Ruperez, Maria
Bresser, Moniek
Kangololo, Bxyn
Bwalya, Justin
Erhardt, Rahel M.
Schaap, Ab
Kasese, Nkatya
Gatchie, Thomas
Floyd, Sian
‘Mota, ‘Mota J.
Ayles, Helen
Shanaube, Kwame
Reither, Klaus
author_facet Klinkenberg, Eveline
Katende, Bulemba
Ruperez, Maria
Bresser, Moniek
Kangololo, Bxyn
Bwalya, Justin
Erhardt, Rahel M.
Schaap, Ab
Kasese, Nkatya
Gatchie, Thomas
Floyd, Sian
‘Mota, ‘Mota J.
Ayles, Helen
Shanaube, Kwame
Reither, Klaus
author_sort Klinkenberg, Eveline
collection PubMed
description BACKGROUND: The health impact of the COVID-19 pandemic largely depends on the ability of the healthcare systems to develop effective and adaptable preparedness and mitigation strategies. A collaborative initiative (BRCCH-EDCTP COVID-19 Initiative) was set up between Lesotho and Zambia early on in the pandemic, to jointly conduct a project to investigate creating access to SARS-CoV-2 screening and testing through community-based COVID-19 case-finding. METHODS: Two different community case-finding strategies were deployed. In Lesotho, an approach was implemented whereby a community (village) health worker screened community members at their home or during community gatherings for COVID-19 signs and symptoms. All community members who screened positive were then offered SARS-CoV-2 testing. In Zambia, so-called community hubs, staffed by community health care workers, were set up at different locations in the community for people to walk in and get tested for SARS-CoV-2. Hubs changed location from week-to-week and targeted transmission hotspots. All persons visiting the hubs were offered testing for SARS-CoV-2 irrespective of self-reported signs and symptoms of COVID-19 though information was collected on occurrence of these. Testing in both approaches was done using SARS-CoV-2 rapid antigen tests. RESULTS: Setting up testing in the community setting was feasible in both countries. In Lesotho in the village health worker approach, over a period of 46 weeks, 7221 persons were screened, and 49 (11.4%) SARS-COV-2 cases identified among 428 COVID-19 screen positive participants. In the community hubs among 3150 people tested, 166 (5.3%) SARS-CoV-2 cases were identified in a period of 26 weeks. From the community hubs approach, where all seen were offered COVID-19 testing it was learned that people screening positive for COVID-19 signs and symptoms were more likely to test SARS-COV-2 positive, especially those reporting classic COVID-19 symptoms like loss of sense/smell for a short period of time (1–3 days). CONCLUSIONS: In conclusion, in this project we learned that implementing COVID-19 screening and testing by lay health workers in the community is possible. Characteristics of the population screened, tested, and identified to have SARS-CoV-2 are described to help guide development of future testing strategies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-023-16306-2.
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spelling pubmed-103643772023-07-25 Creating access to SARS-CoV-2 screening and testing through community-based COVID-19 case-finding, observations from cross-sectional studies in Lesotho and Zambia Klinkenberg, Eveline Katende, Bulemba Ruperez, Maria Bresser, Moniek Kangololo, Bxyn Bwalya, Justin Erhardt, Rahel M. Schaap, Ab Kasese, Nkatya Gatchie, Thomas Floyd, Sian ‘Mota, ‘Mota J. Ayles, Helen Shanaube, Kwame Reither, Klaus BMC Public Health Research BACKGROUND: The health impact of the COVID-19 pandemic largely depends on the ability of the healthcare systems to develop effective and adaptable preparedness and mitigation strategies. A collaborative initiative (BRCCH-EDCTP COVID-19 Initiative) was set up between Lesotho and Zambia early on in the pandemic, to jointly conduct a project to investigate creating access to SARS-CoV-2 screening and testing through community-based COVID-19 case-finding. METHODS: Two different community case-finding strategies were deployed. In Lesotho, an approach was implemented whereby a community (village) health worker screened community members at their home or during community gatherings for COVID-19 signs and symptoms. All community members who screened positive were then offered SARS-CoV-2 testing. In Zambia, so-called community hubs, staffed by community health care workers, were set up at different locations in the community for people to walk in and get tested for SARS-CoV-2. Hubs changed location from week-to-week and targeted transmission hotspots. All persons visiting the hubs were offered testing for SARS-CoV-2 irrespective of self-reported signs and symptoms of COVID-19 though information was collected on occurrence of these. Testing in both approaches was done using SARS-CoV-2 rapid antigen tests. RESULTS: Setting up testing in the community setting was feasible in both countries. In Lesotho in the village health worker approach, over a period of 46 weeks, 7221 persons were screened, and 49 (11.4%) SARS-COV-2 cases identified among 428 COVID-19 screen positive participants. In the community hubs among 3150 people tested, 166 (5.3%) SARS-CoV-2 cases were identified in a period of 26 weeks. From the community hubs approach, where all seen were offered COVID-19 testing it was learned that people screening positive for COVID-19 signs and symptoms were more likely to test SARS-COV-2 positive, especially those reporting classic COVID-19 symptoms like loss of sense/smell for a short period of time (1–3 days). CONCLUSIONS: In conclusion, in this project we learned that implementing COVID-19 screening and testing by lay health workers in the community is possible. Characteristics of the population screened, tested, and identified to have SARS-CoV-2 are described to help guide development of future testing strategies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-023-16306-2. BioMed Central 2023-07-24 /pmc/articles/PMC10364377/ /pubmed/37488552 http://dx.doi.org/10.1186/s12889-023-16306-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Klinkenberg, Eveline
Katende, Bulemba
Ruperez, Maria
Bresser, Moniek
Kangololo, Bxyn
Bwalya, Justin
Erhardt, Rahel M.
Schaap, Ab
Kasese, Nkatya
Gatchie, Thomas
Floyd, Sian
‘Mota, ‘Mota J.
Ayles, Helen
Shanaube, Kwame
Reither, Klaus
Creating access to SARS-CoV-2 screening and testing through community-based COVID-19 case-finding, observations from cross-sectional studies in Lesotho and Zambia
title Creating access to SARS-CoV-2 screening and testing through community-based COVID-19 case-finding, observations from cross-sectional studies in Lesotho and Zambia
title_full Creating access to SARS-CoV-2 screening and testing through community-based COVID-19 case-finding, observations from cross-sectional studies in Lesotho and Zambia
title_fullStr Creating access to SARS-CoV-2 screening and testing through community-based COVID-19 case-finding, observations from cross-sectional studies in Lesotho and Zambia
title_full_unstemmed Creating access to SARS-CoV-2 screening and testing through community-based COVID-19 case-finding, observations from cross-sectional studies in Lesotho and Zambia
title_short Creating access to SARS-CoV-2 screening and testing through community-based COVID-19 case-finding, observations from cross-sectional studies in Lesotho and Zambia
title_sort creating access to sars-cov-2 screening and testing through community-based covid-19 case-finding, observations from cross-sectional studies in lesotho and zambia
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10364377/
https://www.ncbi.nlm.nih.gov/pubmed/37488552
http://dx.doi.org/10.1186/s12889-023-16306-2
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