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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.