Solthis Therapeutic Solidarity and Initiatives for Health

MALISTRENGTHENING SYSTEMS AND HEALTH SERVICESFighting Covid-19

Optimising the fight against Covid-19 in Mali by introducing antigenic tests at community level

Context

In Mali, as in many West African countries, screening for Covid-19 relied almost exclusively on PCR tests, which were only available in 4 laboratories, all located in Bamako. In addition to this limited access, the majority of PCRs were performed for travel purposes, leading to a minority of Covid-19 suspects being identified.

To address this issue, the ECoVAM project initially implemented a new screening strategy at the health centre level, based on a medical triage consultation and the use of rapid tests. This strategy has led to a sharp increase in Covid-19 screening, confirming the importance of SARS-CoV-2 circulation in communities in Mali and demonstrating a rapid, effective and more suitable screening solution than PCR, at all levels of the health pyramid.

Thus, to improve the national response plan against Covid-19, the COVACOM project succeeds the ECoVAM project in introducing this strategy at the community level. The use of SARS-CoV-2 Ag RDTs at the community level by community health workers can allow, thanks to their simplicity of use and rapidity, immediate screening of suspected cases as well as contact cases in order to identify clusters and limit the transmission of COVID-19 in the community The project will be carried out in 4 health zones in the Fana district, comprising a total of 35 community health workers.

Key information about the project

General objective

The project aims to evaluate, in comparison with the national reference strategy in Mali, the impact of a community-based screening strategy for SARS-CoV2 by antigenic tests in people with a clinical suspicion of Covid-19 and in contact cases in four health zones of the Fana district in Mali.

Different studies will be conducted in this perspective to :

• Evaluate the feasibility of this screening strategy at community level for symptomatic patients and contact cases.
• Assess the acceptability of this strategy by patients, community health workers, community leaders and national officials through a qualitative socio-anthropological study.
• To model the cost-effectiveness of implementing this strategy in the Malian health system

Expected results

• To provide concrete results of the implementation of this strategy to guide the Malian authorities in their strategic choices for the Covid-19 response plan.
• To establish whether the use of antigenic tests at community level and by community health workers is an appropriate strategy in this context.
• To assess the requirements and costs of deploying this strategy.

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Know more about the Ecovam/Ecovan project