Within months of the COVID-19 pandemic in 2020, CHAI collaborated with Rwanda’s National Reference Laboratory (NRL) to rapidly plan for and scale up a national testing program. When antigen testing became available, with CHAI support, the Ministry of Health swiftly introduced the test alongside existing polymerase chain reaction (PCR) testing to allow for faster, easier, less expensive, and more widespread testing.
The findings from the first six months of Rwanda’s national antigen testing program have been published in BMJ Open. The findings include data from over 900,000 antigen tests and over 400,000 PCR tests conducted across the country from November 2020-July 2021. In addition, nearly 50 healthcare workers involved in COVID-19 programs and 145 clients who received antigen testing participated in the survey.
The analysis found that the antigen test increased testing availability and case identification compared to PCR. Antigen testing was offered across 1,039 sites nationally including clinics, hospitals, community testing sites, and ports of entry. Antigen tests enabled same-day results return, PCR results took one week or more across some districts due to the need for sample transport and queues for PCR machines. Some healthcare workers and clients identified challenges during the initial antigen program period including intermittent test kit stockouts and limited healthcare staff available to conduct testing. However, overall, qualitative surveys indicated that antigen testing was feasible to implement and acceptable to clients and providers.
In conclusion, Rwanda’s national antigen testing program scaled up rapidly and successfully during the first year of the pandemic, enabling rapid decentralization of testing, faster return of results, and likely reduced transmission. The rapid rollout of this national program can provide lessons for future pandemics.