Contribution of community health care sites to covid-19 screening: pilot experiment through community health care sites in the Democratic Republic of Congo, 2023

Abstract

The establishment of Community Health Care Sites (CHCS) is an opportunity for the use of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigenic rapid diagnostic tests (Ag RDTs) at the community level to contribute to the control of the circulation of SARS-CoV-2. The objective of this study was to evaluate the contribution of CHCS to the detection of Coronavirus disease 2019 (COVID-19) cases in the Democratic Republic of Congo. descriptive cross-sectional study using two approaches: a quantitative approach and a qualitative approach in 112 CHCS. Data on COVID-19 screening during 4 months of implementation of the Foundation for Innovation in New Diagnostics (FIND) project from March to June 2023 as well as the opinions of providers and patients with COVID-19 were collected. Data was analyzed using SPSS for Windows version 24. Absolute and relative frequencies were reported. in total, 5733 patients presented for COVID-19 screening in the CHCS including 1590 (27.7%) in Kinshasa and 4143 (72.3%) in Kongo Central. Suspicious signs of Covid-19 were found among 89.2% of them showed. Among them, 1430 and 3260 patients accepted the screening test in Kinshasa and Kongo Central respectively, i.e. an adherence rate of (89.9%) in Kinshasa and (78.7%) in Kongo Central. Among these cases tested, 4.9% were positive for Ag RDT. CHCS contributed with 23% of the country’s total cases. Among the factors listed by the CHW-CHCSs as determining the search for care for COVID-19 by the community, free availability of COVID-19 Ag-RDT, the awareness of the community raised by the Community health workers (CHWs) delivering care in CHCSs (CHW-CHCS), the friendly welcoming of patients by CHW-CHCS and the geographical proximity of COVID-19 diagnosis through the CHCS established within the community. The health catchment zone management team, registered nurse, community leaders, CHW-CHCSs and patients had expressed the wish to maintain the COVID-19 screening approach in the CHCS for reasons of free testing, bringing the diagnosis closer to the community and the earliness of the test. the use of Ag-RDTs in the CHCS contributes to a rapid improvement in access to screening tests for emerging infectious diseases, particularly for remote populations, and accelerate efforts to interrupt the circulation of infectious agents, especially those with epidemic potential.