Community health sites identified 23% of Congo’s COVID-19 cases in 2023 pilot

Community health care sites in the Democratic Republic of the Congo identified 23% of the country’s COVID-19 cases during a four-month pilot that placed antigen rapid diagnostic testing within communities. A descriptive cross-sectional study assessed 112 sites in Kinshasa and Kongo Central from March through June 2023, combining quantitative screening data with qualitative information from health workers and patients. Among 5,733 people who presented for COVID-19 screening, 4,690 accepted an antigen rapid diagnostic test, and 4.9% of those tested received a positive result.

The pilot was implemented through the Foundation for Innovation in New Diagnostics project and used SARS-CoV-2 antigenic rapid diagnostic tests, or Ag-RDTs, at the community level. Kongo Central accounted for 4,143 people who presented for screening, while Kinshasa accounted for 1,590. The study reported suspicious signs of COVID-19 among 89.2% of those who presented.

After that assessment, 1,430 people in Kinshasa and 3,260 in Kongo Central accepted testing, corresponding to reported adherence rates of 89.9% and 78.7%, respectively. These figures describe acceptance among people who presented at the sites, not changes in COVID-19 prevalence over time. The study examined the operational contribution of community health care sites rather than estimating national disease prevalence.

Its screening records accounted for 23% of the Democratic Republic of the Congo’s total COVID-19 cases during the implementation period, indicating that the network contributed a substantial share of the recorded cases identified in the country during those four months. The descriptive cross-sectional design did not establish how many additional cases would have been identified without the pilot, nor did it demonstrate that community screening reduced transmission, disease severity or deaths. The reported 23% contribution should therefore be understood in relation to the project period and the country’s total recorded cases, not as a counterfactual estimate or a measure of population-level prevalence.

Qualitative responses identified several reported reasons for seeking care and proceeding with screening. Community health workers cited the free availability of COVID-19 Ag-RDTs, awareness raised through their community work, a friendly welcome for patients and the geographical proximity of diagnosis because the sites were located within communities. These reported accounts concern the participants’ experiences and perceptions; the study did not experimentally test the separate influence of each factor on testing uptake.

Members of the health catchment zone management team, registered nurses, community leaders, community health workers and patients said they wanted COVID-19 screening to continue at the sites, citing free testing, closer access to diagnosis and the ability to test earlier.

Subject of Research: Evaluation of community-based COVID-19 antigen rapid diagnostic testing in the Democratic Republic of the Congo

Article Title: Contribution of community health care sites to covid-19 screening: pilot experiment through community health care sites in the Democratic Republic of Congo, 2023

Article References: Mungala, P. M., Nkodila, A. N., Makindu, G. M., Luntadila, P. D., Basikila, P., Bile, P. L., Bukasa, P. K., Nsio, J., Kuzeye, J. N., Tukadila, H. A. K., N’siala, A. K., Kintaudi, L. N. M., Kalonji, A. N., Lukanu, P. N., & Likwela, J. L. (2026). Contribution of community health care sites to covid-19 screening: pilot experiment through community health care sites in the Democratic Republic of Congo, 2023. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15394-1

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15394-1

Keywords: COVID-19 screening, antigen rapid diagnostic tests, community health care sites, Democratic Republic of the Congo, SARS-CoV-2, Kinshasa, Kongo Central, community health workers, health access, infectious disease surveillance, Contribution, community