{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T10:22:53Z","timestamp":1782296573331,"version":"3.54.5"},"reference-count":14,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4_Suppl","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>In Mali, access to health care facilities (HCFs) is limited due to distance and transportation costs, and this limitation may have led to an under detection of COVID-19 cases. This prospective randomized study compared a community-based, integrated COVID-19 and malaria testing strategy (intervention arm) to the national standard-of-care strategy (SOC arm). Four health areas were randomly assigned. All people seeking care who accepted the study were enrolled by community health workers (CHWs) and screened for COVID-19 symptoms. In the intervention arm, CHWs performed COVID-19 and\/or malaria antigen rapid diagnostic tests (Ag-RDTs) for patients who met clinical criteria for possible COVID-19, including fever. In the SOC arm, CHWs referred patients who met clinical criteria for possible COVID-19, including fever, to the nearest health care facility (HCF) where COVID-19 and\/or malaria Ag-RDTs were performed. Febrile patients refusing referral were tested for malaria by CHWs. Among 1,164 patients enrolled, 73% had fever and 72% meet clinical criteria for possible COVID-19. Malaria Ag-RDTs were performed in 79% and 3% COVID-19 suspected patients in intervention and SOC arms, respectively (<jats:italic>P<\/jats:italic> &lt;0.001). Only three patients tested positive for COVID-19. Among 449 patients referred to HCFs, 248 refused to go to the HCFs, and only 10 of 201 who agreed to the referral actually reached one. Among febrile patients, 75% and 34% received malaria treatment in intervention and SOC arms, respectively (<jats:italic>P<\/jats:italic> &lt;0.001). Integration of community-based testing for COVID-19 and malaria Ag-RDTs was found to be feasible. However, limited access to HCFs in rural areas highlights the need for treatment services to be available at the community level.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0855","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T17:42:21Z","timestamp":1741196541000},"page":"3-9","source":"Crossref","is-referenced-by-count":1,"title":["Successful Integration of Community-Based Rapid Antigen Testing for COVID-19 and Malaria in Mali"],"prefix":"10.4269","volume":"112","author":[{"given":"Guillaume","family":"Breton","sequence":"first","affiliation":[{"name":"SOLTHIS, Paris, France;"},{"name":"Department of Infectious Diseases, Piti\u00e9-Salp\u00eatri\u00e8re Hospital, Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issouf","family":"Ma\u00efga","sequence":"additional","affiliation":[{"name":"Solthis, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aboubacar","family":"Ma\u00efga","sequence":"additional","affiliation":[{"name":"Solthis, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabri\u00e8le Laborde","family":"Balen","sequence":"additional","affiliation":[{"name":"IRD-TransVIHMI UMI 233\/ INSERM 1175 Universit\u00e9 de Montpellier, Montpellier, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Sagaon-Teyssier","sequence":"additional","affiliation":[{"name":"Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Sant\u00e9 & Traitement de l\u2019Information M\u00e9dicale, ISSPAM, Marseille, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Hoppe","sequence":"additional","affiliation":[{"name":"FIND, Geneva, Switzerland;"},{"name":"Elizabeth Glaser Pediatric AIDS Foundation, Geneva, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Od\u00e9 Kanku","family":"Kabemba","sequence":"additional","affiliation":[{"name":"Solthis, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boubacar","family":"Ciss\u00e9","sequence":"additional","affiliation":[{"name":"Solthis, Bamako, Mali;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatou Diawara","family":"Traore","sequence":"additional","affiliation":[{"name":"National Institut of Public Health (INSP), Bamako, Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1"},{"key":"b2","series-title":"Diagn Microbiol Infect Dis","first-page":"116027","article-title":"Rapid antigen tests for SARS-CoV-2-a synopsis of the medical evidence","volume":"107","author":"Wertenauer","year":"2023"},{"key":"b3","series-title":"Antigen-Detection in the Diagnosis of SARS-CoV-2 Infection","year":"2023"},{"key":"b4","series-title":"Six in Seven COVID-19 Infections go Undetected in Africa","year":"2023"},{"key":"b5","series-title":"Clin Infect Dis","first-page":"1030","article-title":"Rapidly increasing severe acute respiratory syndrome coronavirus 2 seroprevalence and limited clinical disease in 3 Maliancommunities: A prospective cohort study","volume":"74","author":"Sagara","year":"2022"},{"key":"b6","series-title":"Epidemiol Infect","first-page":"e213","article-title":"Spreading of SARS-CoV-2 in West Africa and assessment of risk factors","volume":"148","author":"Tinto","year":"2020"},{"key":"b7","series-title":"Int J Tuberc Lung Dis","first-page":"S414","article-title":"Evaluation of a strategy combining medical triage and SARS-CoV-2 Ag-RDTs to improve the diagnosis of COVID-19 in health facilities in Mali","volume":"26","author":"Breton","year":"2022"},{"key":"b8","series-title":"COVID-19 Case 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