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Restoring ECOVAN's findings to enhance Covid-19 screening in Niger

Discover how ECOVAN's research in Niger revolutionized Covid-19 screening with rapid antigen testing. Learn how this approach increased diagnosis rates, reduced wait times, and enhanced patient care. Find out the implications for the national pandemic response plan and the importance of prioritizing immunization for those most at risk. Watch the video to see the impact on the ground.

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ECOVAN is an operational research project done by Soltis in conjunction with the Ministry of Public Health, Population and Social Affairs of Niger, and the Center for Medical and Health Research (CERMES) with funding from FIND (Foundation for Innovative New Diagnostics).

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The research tested antigenic testing for quick detection of Covid<1>19 at 8 health sites in Niamey and Dosso from November 2021 to April 2022.

The initiative included a triage medical consultation to seek clinical signs of Covid-19 in consulting patients, followed by a fast screening antigen test for all Covid-19 suspects.

The ECOVAN research assessed the operationality of this approach and provided evidence to health authorities to alter the national pandemic response plan. What's the study's conclusion?

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Before this research, Covid-19 was diagnosed via a PCR test only accessible at CERMES in Niamey and several regional labs.

Most PCR tests were travel-related. The antigen test was only used for travelers on request or at borders.

Health institutions identified a few Covid-19 suspects.

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The implementation of a triage device using a computer application on a tablet and rapid antigenic tests at the level of health structures has allowed a sharp increase in the diagnosis of Covid-19, demonstrating a rapid, effective, and more adapted screening strategy than PCR at all levels of the health pyramid, especially at health centers that had never been diagnosed before.

The ECOVAN project documented the community impact of Covid-19.

19% of patients who visited the 8 health institutions throughout the trial exhibited Covid-19-compatible symptoms, and 6% had a positive fast test.

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Rapid tests are straightforward to use and highly accepted by caregivers, shortening wait times for patient findings.

"With the antigen test, the result is acquired within 15 minutes whereas for PCR the wait is at least 24 hours," says Dr. Diakité Oumarou, leader of the ECOVAN project. "This might affect the duration of care if the test is positive."

This gadget has also helped caretakers manage the condition and de-dramatize Covid-19 "Before, we hesitated because it created complications: waiting time, unsatisfied patients.

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The wait was excruciating for the patient and the caregiver, who was often told, "It's not Covid." We reduced and refocused.

Now it's reversed "says a research caregiver. Despite the evident interest in adopting quick tests for Covid-19 diagnosis, systematic screening for Covid-19 (triage) creates important workload problems for caregivers, making it difficult to implement in health institutions.

These findings suggest antigenic testing to be made accessible in hospitals where the most severe forms of Covid-19 are observed, and more generally for diagnosing those most at risk of severe Covid-19, those over 65 or with comorbidities like diabetes. Covid-19 is a prevalent disorder in Niger, however, it's usually not significant.

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Given the danger, facilitating the detection of the condition is not enough; they must have priority access to immunization, which decreases death by 90%.

The outcomes of this research will advise the Ministry of Public Health, Population and Social Affairs on the success of this covid-19 diagnosis technique via fast testing, to propose decentralizing it. Over 80 health professionals from Niamey and Dosso have been trained to scale up this method.

A patient undergoes a screening test at the CSI Talladjé in Niamey following a triage medical consultation supported by a tablet decision assistance program.

Find a video filmed on the ECOVAN project with interviews and photographs of the activities on the ground via the links.

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