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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)

From: Improving community health worker use of malaria rapid diagnostic tests in Zambia: package instructions, job aid and job aid-plus-training

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)*

  1. * Significant at p < 0.05.