Table 3.
Item analysis of test steps by category: preparation and documentation, RDT use, and safe handling and disposal for CHWs using manufacturer's instructions, job aid-only, and job aid-plus-training (N = 79)
| Test steps (organized by category) |
% participants who performed step correctly |
Difference (%) (95% CI) | |||
| Manufacturer's instructions (n = 32) |
Job aid only (n = 21) |
Job aid- plus-training (n = 26) |
Manufacturer's instructions vs. Job aid-only |
Job aid-only vs. Job aid-plus- training |
|
| Preparation and documentation | |||||
| 1. Assembles packet, buffer, swab, lancet | 48 | 86 | 85 | +37 (14, 60)* | -1 (-22, 19) |
| 2. Removes contents of test packet | 91 | 90 | 85 | -1 (-17, 16) | -5 (-24, 14) |
| 3. Writes patient's name on cassette | 16 | 76 | 77 | +61 (38, 83)* | +1 (-24, 25) |
| 4. Selects 4th finger on left hand; cleans it with alcohol swab, and allows it to air dry | 26 | 57 | 96 | +31 (5, 58)* | +39 (17, 61)* |
| 5. Records results in CHW register | 62 | 38 | 73 | -24 (-51, 3) | +35 (8, 62)* |
| Sub-total for category: | 49 | 69 | 83 | +20 (7, 34)* | +14 (1, 27)* |
| RDT Use | |||||
| 1. Checks expiry date on test package | 21 | 67 | 96 | +46 (21, 71)* | +29 (8, 51)* |
| 2. Collects film of blood with enclosed loop making sure to fill the loop completely | 63 | 90 | 73 | +28 (7, 49)* | -17 (-39, 4) |
| 3. Using the loop, blots blood on the pad in sample well A | 72 | 95 | 100 | +23 (5, 41)* | +5 (-4, 14) |
| 4. Dispenses six drops of clearing buffer into well B | 81 | 100 | 96 | +19 (5, 33)* | -4 (-11, 4) |
| 5. Waits 15 minutes before reading results | 70 | 90 | 92 | +20 (0, 41) | +2 (-14, 18) |
| Sub-total for category: | 61 | 89 | 92 | +28 (16, 39)* | +3 (-4, 10) |
| Safe handling and disposal | |||||
| 1. Puts on new pair of gloves | 66 | 86 | 96 | +20 (-2, 42) | +10 (-6, 27) |
| 2. Using a sterile lancet, punctures finger | 88 | 86 | 96 | -2 (-21, 17) | +10 (-7, 27) |
| 3. Discards lancet in sharps bin immediately after pricking finger. Does not set it down first. | 41 | 62 | 96 | +21 (-6, 48) | +34 (12, 56)* |
| 4. Discards the loop in the sharps box | 55 | 90 | 100 | +36 (14, 57)* | +10 (-3, 22) |
| 5. Disposes of gloves, wrappers, alcohol swab, loop, desiccant and cassette in non-sharps container | 45 | 76 | 85 | +31 (6, 56)* | +8 (-14, 31) |
| Sub-total for category: | 58 | 80 | 95 | +22 (7, 36)* | +15 (5, 25)* |
| Interpretation of results | |||||
| 1. Reads test results correctly | 72 | 86 | 96 | +13 (-9, 35) | +10 (-6, 27) |
| Total (all 16 steps) | 57 | 80 | 90 | +23 (13, 33)* | +10 (3, 17)* |
* Significant at p < 0.05.