Fig 1.
Flow chart depicting the RISE project operational and data collection activities.
The RISE project utilized a mixed methods approach to evaluate the RDT implementation in 2023: 1) a monthly cholera RDT utilization survey emailed to all 114 EWARS facilities that received RDTs through RISE, 2) individual level data collection at 12 EWARS facilities in Kathmandu Valley, and 3) qualitative interviews. The monthly survey included questions on number of cholera RDTs in stock, number of RDTs used, and number of positive RDTs. Sites participating in individual level data collection (which included 6 health facilities participating in the IVI’s intensive surveillance study and 6 facilities that were supported through the EWARS national surveillance system directed by the Epidemiology and Disease Control Division (EDCD)) completed an individual RDT survey each time an RDT was used. The survey included questions on patient age and sex, RDT result, confirmatory testing done, patient symptoms, antibiotic use, final diagnosis, and reporting to EWARS. All used RDTs were preserved for PCR testing to confirm the result [20]. We evaluated the use and implementation of cholera RDTs in the national EWARS sentinel sites compared to sites receiving intensive research-based surveillance through IVI.
Table 1.
Guiding themes used during open coding analysis of interviews.
Table 2.
Exemplary participant quotes categorized by topic.
Table 3.
Interviewee suggestions for training on cholera RDTs.