O7.5 - Perceived benefits and implementation considerations for a novel lateral flow assay for the point-of-care detection of Neisseria gonorrhoeae in public healthcare facilities in South Africa

BACKGROUND

Rapid point-of-care tests (POCT) have the potential to replace syndromic management of sexually transmitted infections (STI). An important component of POCT integration in primary healthcare is to understand end-user acceptance and perceived implications for clinical practice. We qualitatively assessed implementation experiences of a novel POCT lateral flow assay and reader prototype (NG-LFA) amongst healthcare workers in the Eastern Cape.

METHODS

As part of a performance evaluation, a qualitative time-series assessment of the NG-LFA was conducted and informed by the Health Technology Adoption Framework. Trained healthcare workers (HCW) used the NG-LFA over 6 months with interviews conducted at pre-implementation (post-training), initial device use, and 3- and 6-month study implementation. All interviews were audio-recorded, transcribed, and then analysed using Dedoose.

RESULTS

A total of 66 interviews were conducted with 25 HCWs (11 healthcare professionals and 14 fieldworkers). HCW satisfaction with NG-LFA was demonstrated through enhanced patient receptivity for STI testing, and perceived device suitability by discussing implementation steps at primary healthcare level (Table 1). Specifically, targeted testing, witnessing the testing process, and receiving results quickly were perceived to facilitate patient receptivity, privacy and trust in the NG-LFA. In turn, the NG-LFA had the potential to benefit clinical decision-making for STI treatment, and the ability to reduce recurring patient visits. Prospective NG-LFA implementation considerations for clinic integration included space constraints for specimen collection, patient flow, and HCW workload for provider- vs. self-collected samples. Device implementation recommendations included offering sufficient STI education to patients, and a design that can test for more than one STI type.

DISCUSSION

Findings revealed high acceptability and satisfaction amongst HCWs through the perceived benefits of targeted testing and treatment for patients. User experiences support future clinic service integration, highlighting the importance of assessing patient-provider communication, organizational readiness, and training aspects.