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. 2024 Jul 13:74:102730.
doi: 10.1016/j.eclinm.2024.102730. eCollection 2024 Aug.

Improving COVID-19 contact tracing and testing of exposed individuals in Cameroon using digital health technology: a cluster randomised trial

Boris Tchakounte Youngui  1 , Albert Mambo  2 , Rhoderick Machekano  3 , Rogacien Kana  1 , Emilienne Epée  4 , Sylvain Zemsi Tenkeu  1 , Philippe Narcisse Tsigaing  1 , Marie Louise Aimée Ndongo  1 , Christelle Mayap Njoukam  2 , Lawane Bichara  2 , Tatiana Djikeussi Katcho  1 , Muhamed Awolu Mbunka  1 , Terence Acheliu Longla  1 , Leonie Simo  1 , Adrienne Vanessa Kouatchouang  1 , Patrice Tchendjou  1 , Appolinaire Tiam  3   5 , Laura Guay  3   5 , Khairunisa Suleiman  6 , Olukunle Akinwusi  6 , Rigveda Kadam  6 , Paula Akugizibwe  6 , Mario Songane  7 , Godfrey Woelk  3 , Boris Kevin Tchounga  1 ; DTECT study group
Collaborators, Affiliations

Improving COVID-19 contact tracing and testing of exposed individuals in Cameroon using digital health technology: a cluster randomised trial

Boris Tchakounte Youngui et al. EClinicalMedicine. .

Abstract

Background: Contact tracing was described as a key strategy to contribute to controlling the spread of severe acute respiratory syndrome of Coronavirus 2 (SARS-CoV-2) but implementing it can be a challenge. Digitalisation of contact tracing is among the proposed solutions being explored in sub-Saharan African settings. We assessed the effectiveness of a digital tool to expand SARS-CoV-2 testing in exposed individuals in Cameroon.

Methods: We conducted a cluster-randomised (1:1) trial in eight health districts, including 22 facilities and SARS-CoV-2 testing units, randomly assigned to a digital (intervention) or standard (control) contact tracing approach. The intervention consisted of a contact tracing module added to the digital platform "Mamal PRO" used for monitoring and coordination of Coronavirus Disease 2019 pandemic response in Cameroon. The primary outcome was the proportion of contacts declared by SAR-CoV-2 index patients who were successfully traced and tested for SARS-CoV-2 evaluated with a Poisson regression model with cluster adjustment. This study is registered with ClinicalTrials.gov (NCT05684887).

Findings: Between October 18, 2022, and March 31, 2023, we enrolled 164 index patients in the intervention arm and 149 in the control arm, who identified 854 and 849 contacts, respectively. In the intervention arm, 93.8% (801/854) of identified contacts were successfully reached by the tracing unit versus 54.5% (463/849) in the control arm. The intervention significantly increased the likelihood of successfully tracing contacts (adjusted relative risks (RR) 1.72 [95% CI: 1.00-2.95], p = 0.049). The median (interquartile range, IQR) time to successfully tracing contacts was 0 days [IQR: 0, 1] in the intervention and 1 day [IQR: 0, 2] in the control arm. In the intervention arm, 21.3% (182/854) of identified contacts received SARS-CoV-2 testing compared to 14.5% (123/849) in the control arm (adjusted RR 1.47 [95% CI: 0.44-4.90], p = 0.530).

Interpretation: Digitalising the contact tracing process improved exposure notification and facilitated the tracing of a greater number of contacts of individuals infected with SARS-CoV-2 in resource-limited settings.

Funding: The study was funded by FIND, United Kingdom (FCDO 40105983), Switzerland (81066910), Netherlands (SDD 4000004160), Canada (DFATD 7429348), The Kingdom of Saudi Arabia (FIND-ACT-A DX PARTNERSHIP 20.08.2020), The Rockefeller Foundation (2020 HTH 059), Germany (BMZ Covid-19 Diagnostic and Surveillance Response 27.07.2021), Australia (DFAT 76442), Kuwait (M239/2020), The Government of Portugal and Partners (ANF, BCP, CGF, APIFARMA) and The BlackRock Foundation (Grant Agreement as of April 20, 2022).

Keywords: COVID-19; Cluster randomised trial; Contact tracing; Digital health; m-Health.

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Conflict of interest statement

BKT has received support from FIND (through funding for the AFCON grant paid to his institution) to participate to a meeting on operational research in Kigali and the CPHIA conference. All other authors declared no competing interests to disclose.

Figures

Fig. 1
Fig. 1
Trial profile.
See this image and copyright information in PMC

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