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Sustainable Development Goals
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INTEGRATION OF SERIAL SELF-TESTING FOR COVID-19 AS PART OF CONTACT TRACING IN THE BRAZILIAN PUBLIC HEALTH SYSTEM: A PRAGMATIC TRIAL PROTOCOL
Ensayo Clínico Pragmático
Asignación de Recursos para la Atención de Salud
Planificación en Salud
COVID-19
Ensaio Clínico Pragmático
Alocação de Recursos para a Atenção à Saúde
Planejamento em Saúde
Author
Affilliation
PATH. Seattle, Washington, USA.
Global Health Strategies. Rio de Janeiro, RJ, Brasil.
PATH. Seattle, Washington, USA.
Centro de Pesquisa de Medicina Tropical de Rondônia. Porto Velho, RO, Brasil.
Centro de Pesquisa de Medicina Tropical de Rondônia. Porto Velho, RO, Brasil.
Fundação Oswaldo Cruz. Instituto Carlos Chagas. Laboratório de Ciências e Tecnologias Aplicadas em Saúde. Curitiba, PR, Brasil.
Global Health Strategies. Rio de Janeiro, RJ, Brasil.
Global Health Strategies. Rio de Janeiro, RJ, Brasil.
PATH. Seattle, Washington, USA.
Fundação Oswaldo Cruz. Instituto Carlos Chagas. Laboratório de Ciências e Tecnologias Aplicadas em Saúde. Curitiba, PR, Brasil.
Centro de Pesquisa de Medicina Tropical de Rondônia. Porto Velho, RO, Brasil.
Global Health Strategies. Rio de Janeiro, RJ, Brasil.
PATH. Seattle, Washington, USA.
Centro de Pesquisa de Medicina Tropical de Rondônia. Porto Velho, RO, Brasil.
Centro de Pesquisa de Medicina Tropical de Rondônia. Porto Velho, RO, Brasil.
Fundação Oswaldo Cruz. Instituto Carlos Chagas. Laboratório de Ciências e Tecnologias Aplicadas em Saúde. Curitiba, PR, Brasil.
Global Health Strategies. Rio de Janeiro, RJ, Brasil.
Global Health Strategies. Rio de Janeiro, RJ, Brasil.
PATH. Seattle, Washington, USA.
Fundação Oswaldo Cruz. Instituto Carlos Chagas. Laboratório de Ciências e Tecnologias Aplicadas em Saúde. Curitiba, PR, Brasil.
Centro de Pesquisa de Medicina Tropical de Rondônia. Porto Velho, RO, Brasil.
Abstract
The coronavirus disease (COVID-19) pandemic has led to an unprecedented public health crisis. Insufficient testing continues to limit the effectiveness of the global response to the COVID-19 pandemic. Molecular testing methods such as reverse transcriptase polymerase chain reaction (RT-PCR) continue to be highly centralized and are a sub-optimal option for population surveillance. Rapid antigen tests (Ag-RDTs) offer multiple benefits including low costs, high flexibility to conduct tests in a wide variety of settings, and faster return of results. Self-test Ag-RDTs (STs) have gained approval in several markets and offer the possibility to expand testing, reaching at-risk populations. While STs have the potential to assist the COVID-19 response, test result integrity, reporting, and appropriate linkage to care continue to hinder the widespread implementation of self-testing programs. This protocol presents a mixed-methods pragmatic trial (ISRCTN91602092) to better understand the feasibility of self-testing as part of a contact tracing strategy within the Brazilian public health system. Approximately 604 close contacts of 150 index cases testing positive for COVID-19 will be enrolled. Index cases will be randomized for their close contacts to participate in either serial (daily) self-testing over a 10-day follow-up period or a more traditional approach to contact tracing with a professional Ag-RDT at one time point post-exposure. Usability workshops and focus group discussions will also be conducted. This study protocol presents a comprehensive plan to assess the effectiveness, operational feasibility, and stakeholder preferences of a serial self-testing strategy for contact tracing within the Brazilian public health system. Our results will contribute to a better understanding of the feasibility of a self-testing strategy within the public sector. Potential risks and limitations are discussed. Our findings will have important implications as governments continue working to mitigate the impact of COVID-19, particularly in the context of where to direct limited resources for testing and healthcare infrastructure.
Keywords in Spanish
AutoevaluaciónEnsayo Clínico Pragmático
Asignación de Recursos para la Atención de Salud
Planificación en Salud
DeCS
AutotesteCOVID-19
Ensaio Clínico Pragmático
Alocação de Recursos para a Atenção à Saúde
Planejamento em Saúde
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