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Karanja S, Aduda J, Thuo R, Wamunyokoli F, Oyier P, Kikuvi G, Kissinger H, Gachohi J, Mburugu P, Kamau D, Matheri J, Mwelu S, Machua J, Amoth P, Mariga D, Were I, Mohamed M, Kimuyu J, Saigilu S, Wangeci R, Mubadi K, Ndung’u J, Suleiman K, Kadam R, Akugizibwe P. Utilization of digital tools to enhance COVID-19 and tuberculosis testing and linkage to care: A cross-sectional evaluation study among Bodaboda motorbike riders in the Nairobi Metropolis, Kenya. PLoS One 2023; 18:e0290575. [PMID: 37682928 PMCID: PMC10490987 DOI: 10.1371/journal.pone.0290575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/11/2023] [Indexed: 09/10/2023] Open
Abstract
Kenya has registered over 300,000 cases of COVID-19 and is a high-burden tuberculosis country. Tuberculosis diagnosis was significantly disrupted by the pandemic. Access to timely diagnosis, which is key to effective management of tuberculosis and COVID-19, can be expanded and made more efficient through integrated screening. Decentralized testing at community level further increases access, especially for underserved populations, and requires robust systems for data and process management. This study delivered integrated COVID-19 and tuberculosis testing to commercial motorbike (Bodaboda) riders, a population at increased risk of both diseases with limited access to services, in four counties: Nairobi, Kiambu, Machakos and Kajiado. Testing sheds were established where riders congregate, with demand creation carried out by the Bodaboda association. Integrated symptom screening for tuberculosis and COVID-19 was conducted through a digital questionnaire which automatically flagged participants who should be tested for either, or both, diseases. Rapid antigen-detecting tests (Ag-RDTs) for COVID-19 were conducted onsite, while sputum samples were collected and transported to laboratories for tuberculosis diagnosis. End-to-end patient data were captured using digital tools. 5663 participants enrolled in the study, 4946 of whom were tested for COVID-19. Ag-RDT positivity rate was 1% but fluctuated widely across counties in line with broader regional trends. Among a subset tested by PCR, positivity was greater in individuals flagged as high risk by the digital tool (8% compared with 4% overall). Of 355 participants tested for tuberculosis, 7 were positive, with the resulting prevalence rate higher than the national average. Over 40% of riders had elevated blood pressure or abnormal sugar levels. The digital tool successfully captured complete end-to-end data for 95% of all participants. This study revealed high rates of undetected disease among Bodaboda riders and demonstrated that integrated diagnosis can be delivered effectively in communities, with the support of digital tools, to maximize access.
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Affiliation(s)
- Simon Karanja
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - Jane Aduda
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - Reuben Thuo
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - Fred Wamunyokoli
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - Philip Oyier
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - Gideon Kikuvi
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - Henry Kissinger
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - John Gachohi
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - Patrick Mburugu
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - David Kamau
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - Joseph Matheri
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - Susan Mwelu
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | | | | | | | - Ian Were
- Ministry of Health Kenya, Nairobi, Kenya
| | - Musa Mohamed
- Department of Health Services, Nairobi Metropolitan Services, Nairobi, Kenya
| | - Judith Kimuyu
- Department of Health Services Machakos County, Machakos, Kenya
| | - Samson Saigilu
- Department of Health Services Kajiado County, Nairobi, Kenya
| | - Rose Wangeci
- Department of Health Services Kiambu County, Kiambu, Kenya
| | - Kevin Mubadi
- Bodaboda Safety Association of Kenya, Nairobi, Kenya
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