{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T08:52:04Z","timestamp":1793350324246,"version":"4.5.0"},"reference-count":21,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T00:00:00Z","timestamp":1682467200000},"content-version":"unspecified","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009977","name":"ELMA Foundation","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100009977","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,3,29]]},"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Reverse transcriptase PCR is the most sensitive test for SARS-CoV-2 diagnosis. However, the scale-up of these tests in low-income and middle-income countries (LMICs) has been limited due to infrastructure and cost. Antigen rapid diagnostic tests are an alternative option for diagnosing active infection that may allow for faster, easier, less expensive and more widespread testing. We compared the implementation of antigen and PCR testing programmes in Rwanda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We retrospectively reviewed routinely collected PCR and antigen testing data for all reported tests conducted nationally. We administered semiquantitative surveys to healthcare workers (HCWs) involved in COVID-19 testing and care and clients receiving antigen testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Rwanda, November 2020\u2013July 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>National SARS-CoV-2 testing data; 49 HCWs involved in COVID-19 testing and care; 145 clients receiving antigen testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>None (retrospective analysis of programme data).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Test volumes, turnaround times, feasibility and acceptability of antigen testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data from 906\u2009204 antigen tests and 445 235 PCR tests were included. Antigen testing increased test availability and case identification compared with PCR and had a median results return time of 0\u2009days (IQR: 0\u20130). In contrast, PCR testing time ranged from 1 to 18 days depending on the sample collection site\/district. Both HCWs and clients indicated that antigen testing was feasible and acceptable. Some HCWs identified stockouts and limited healthcare staff as challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Antigen testing facilitated rapid expansion and decentralisation of SARS-CoV-2 testing across lower tier facilities in Rwanda, contributed to increased case identification, reduced test processing times, and was determined to be feasible and acceptable to clients and providers. Antigen testing will be an essential component of SARS-CoV-2 test and treat programmes in LMICs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-066776","type":"journal-article","created":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T13:25:25Z","timestamp":1682515525000},"page":"e066776","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Implementing SARS-CoV-2 antigen testing scale-up in Rwanda: retrospective analysis of national programme data and qualitative findings"],"prefix":"10.1136","volume":"13","author":[{"given":"Robert","family":"Rutayisire","sequence":"first","affiliation":[{"name":"National Reference Laboratory, Rwanda Biomedical Center, Kigali, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1939-1307","authenticated-orcid":false,"given":"Caroline E","family":"Boeke","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3860-4673","authenticated-orcid":false,"given":"Jessica","family":"Joseph","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namita","family":"Bansal","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noella","family":"Bigirimana","sequence":"additional","affiliation":[{"name":"Rwanda Biomedical Center, Kigali, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen","family":"Demke","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Kallarakal","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prosper","family":"Karame","sequence":"additional","affiliation":[{"name":"Research, Innovation and Data Science, Rwanda Biomedical Center, Kigali, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigue","family":"Ndayishimiye","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative, Kigali, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esperance","family":"Umumararungu","sequence":"additional","affiliation":[{"name":"National Reference Laboratory, Rwanda Biomedical Center, Kigali, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor","family":"Peter","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaukat","family":"Khan","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,4,26]]},"reference":[{"key":"2025120618232581000_13.4.e066776.1","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1016\/S1473-3099(21)00146-8","article-title":"Diagnostic performance of different sampling approaches for sars-cov-2 rt-pcr testing: a systematic review and meta-analysis","volume":"21","author":"Tsang","year":"2021","journal-title":"Lancet Infect Dis"},{"key":"2025120618232581000_13.4.e066776.2","doi-asserted-by":"crossref","first-page":"6","DOI":"10.11604\/pamj.2021.38.6.26902","article-title":"The challenges of covid-19 testing in africa: the ethiopian experience","volume":"38","author":"Mulu","year":"2021","journal-title":"Pan Afr Med J"},{"issue":"Supp 2","key":"2025120618232581000_13.4.e066776.3","doi-asserted-by":"crossref","DOI":"10.11604\/pamj.2020.35.4.22703","article-title":"SARS-cov-2 diagnostic testing in Africa: needs and challenges","volume":"35","author":"Adebisi","year":"2020","journal-title":"Pan Afr Med J"},{"key":"2025120618232581000_13.4.e066776.4","first-page":"071","article-title":"Result turnaround time of RT-PCR for SARS-cov-2 is the main cause of COVID-19 diagnostic delay: A country-wide observational study of mexico and colombia","volume":"74","author":"N\u00fa\u00f1ez","year":"2022","journal-title":"Rev Invest Clin"},{"key":"2025120618232581000_13.4.e066776.5","unstructured":"WHO . 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