No Statement | Factors | |||||
---|---|---|---|---|---|---|
F1 | F2 | F3+ | F3− | F4 | ||
Context (Use Case) | ||||||
1 | Microscopy using a concentration technique is the recommended method to prove active schistosomiasis, despite its low sensitivity and need for expert users. | 0 | −1 | −1 | −2 | −3 |
2 | Diagnosis should include the identification of Schistosoma parasites in both humans and water sources that may be contaminated. | +2 | 0 | +4 | +2 | 0 |
3 | Mass screening and diagnosis should be carried out alongside mass drug administration with praziquantel. | −2 | −3 | +4 | −2 | 5 |
4 | Schistosomiasis surveillance enables program managers to monitor the effectiveness of intervention strategies and identify which populations require continuing interventions. | −1 | +5 | +2 | −1 | +3 |
5 | The availability of RDTs, which requires only minimal infrastructure, would improve diagnosis and surveillance simultaneously. | +3 | −2b | +3 | +2 | +5 |
6 | Implementing an affordable and simple POC diagnostics solution will reduce the financial burden of equipment and personnel at each health facility. | 0b | −2 | −2 | 4b | −1 |
7 | POC diagnostics that can detect and confirm cases immediately will reduce the risk of missed or misdiagnosed cases. | +2 | 0 | −3a | 0 | 1 |
8 | The quantification of egg excretion helps to assess the transmission potential of populations living in endemic areas. | −1 | −2 | 1 | −1 | −2 |
9 | Schistosomiasis control programs should target school-aged children only. | −6 | −6 | −1b | −5 | −6 |
10 | Due to the low level of education and lack of training among community health workers, incorrect treatment is often prescribed. | −3a | −1 | 0 | 0 | 3b |
11 | Presenting data on the severity of schistosomiasis infection of specific locations will guide the development of strategies for effective case management and control elimination. | +1 | +2 | −6b | +3 | +1 |
12 | Passive case detection, based on people’s self-reporting, has been considered a less expensive strategy for the control of schistosomiasis. | −3 | −2 | 6b | 0 | 0 |
13 | Prevalence and intensity of infection is often higher among children than among adults. | 0 | −1 | −3 | +1 | 0 |
Infrastructure and location | ||||||
14 | Schistosomiasis diagnosis should be done closest to the community as it reduces the time to carry samples back to the laboratory. | 0 | +1 | 2 | 0 | +4 |
15 | Diagnostic and treatment campaigns should target school-age children, adolescents and those whose occupations involve contact with infectious water (e.g. fishing, farming, irrigation, and domestic tasks in water). | −2 | +3 | +1 | +1 | −1 |
16 | Simple, rapid POC tests should be used in primary health care settings where patients often travel long distances to access health care facilities. | −1 | −1 | −2 | +2 | +2 |
17 | Diagnostic devices should be deployed in primary health care centers, clinics, and health posts since they are the most lacking in equipment. | −4a | +4 | −1a | +5 | 1a |
18 | Testing of urine samples for schistosomiasis with school-based surveys should be done at the school location. | −1 | +1 | 0 | −2 | −5 |
19 | It is convenient to treat patients for schistosomiasis infection without a confirmed diagnosis due to the delay in receiving test results from referral hospitals. | −5 | −5 | −5 | −4 | −4 |
Product requirement | ||||||
20 | Schistosomiasis elimination calls for developing novel diagnostic tools with higher sensitivity and specificity than microscopes. | +1 | 3b | −4 | −1 | −3 |
21 | Diagnostic device for schistosomiasis with minimal to no sample preparation is ideal. | −2 | −3 | −2 | −3 | −5a |
22 | The diagnostic device should quantify eggs to provide an estimation of the number of people that have been exposed to schistosomiasis in a population. | 5a | −5b | +1 | −1a | +2 |
23 | Devices should be easy to use by medical personnel and health workers such as CHEWs, CHOs, laboratory scientists to detect and diagnose schistosomiasis-infected patients. | +1 | +2 | 0 | −5 | −2 |
24 | Patient samples should be processed in batches to get a faster turnaround time and increase the efficiency of sample processing during mass campaigns or sensitization meetings. | 0 | 0 | +1 | −4b | +3 |
25 | Ideal diagnostic approaches should allow the concurrent detection of several pathogens in different biological samples such as urine, blood, and stool. | +3 | 0 | +3 | −3a | +1 |
26 | Diagnostic devices should be sensitive enough for detecting very light schistosomiasis infections. | +4 | −3 | +5 | −1 | −1 |
27 | Diagnostic devices should have their own reliable power sources due to the unstable power connectivity in rural and distant communities. | +6 | −1 | −1 | +6 | +6 |
28 | The best diagnostic devices should be easy to transport safely by car, motorbike, and bicycle to remote locations. | 4a | +1 | −4 | +2 | −1 |
29 | Diagnostic devices should be compact and portable so that they can be easily deployed in the community. | +2 | 0a | +3 | +3 | −3b |
30 | Diagnostic devices/tests should identify and map out areas with a large spread of schistosomiasis and be able to trace the source of the disease. | 3a | 0 | 0 | 0 | −1 |
31 | Devices should be locally repaired and maintained by local technicians in case of breakdown. | 0 | +2 | −5b | +4 | 0 |
32 | The device should be easy to clean and disinfect to prevent re-contamination. | +1 | +1 | 0 | +1 | +2 |
Rollout strategy | ||||||
33 | The cost per diagnostic test should be free (covered by the government). | −1 | 4a | 0 | +1 | −2 |
34 | Cost per diagnostic test should be less than 1,000 Naira (US$2). | −5b | 6a | −3 | +3a | −2 |
35 | Mass drug administration campaigns should be accompanied by mass diagnostic and disease awareness campaigns. | −2 | +2 | +2 | 1 | 0 |
36 | Data from diagnostic devices should be accessible to stakeholders (local government, DSNO, MOH, researchers, and NGOs) to enhance planning. | +1 | +5 | +2 | 0 | +2 |
37 | New interventions should consider training the health care workers at the community level and the informal sector (PMVs and traditional medicine) to increase coverage to diagnostics. | −3 | +1 | −1 | −6b | 0 |
38 | Diagnostic tools for schistosomiasis should be deployed and used at the community level by PMVs and community mobilizers as they already serve as trusted stakeholders in the community. | −4 | −4 | 1b | −3 | −4 |
39 | The role of the village/community head is important in the acceptance of the new diagnostic device. | +5 | −4a | −2a | +5 | 1b |
40 | Patients with schistosomiasis should be tested before being treated. | +2 | +3 | +5 | −2b | +4 |
Abbreviations: CHEW, community health extension worker; CHO, community health officer; DSNO, disease surveillance notification officer; MOH, medical officer of health; NGO, nongovernmental organization; PMV, patent medicine vendor; POC, point-of-care; RDT, rapid diagnostic test.
↵a Distinguishing statement significant at P<.05.
↵b Distinguishing statement significant at P<.01.