Antigen detection tests to be conducted in all urban primary health centres in GurugramUpdated: Aug 05, 2020, 00:13 IST
In order to ramp up the testing capacity, the district health department has decided to allow rapid antigen detection tests for Covid-19 in all the 19 urban primary health centres (UPHCs) in the city, starting Wednesday. Earlier this month, the primary health centres were also allowed to collect samples for the reverse transcription-polymerase chain reaction(RT-PCR) tests at the local level and transport these samples to the government lab at the Civil Hospital, Sector 10. The decision to allow UPHCs to conduct both antigen and RT-PCR tests is a part of the ongoing efforts to improve the health infrastructure in the city by strengthening the primary health centres, said officials.
Experts say that strengthening UPHCs for Covid-19 sample collection and testing would help in the early detection of suspected cases that would prevent mortality and help in spreading public awareness regarding the disease.
The district health department has conducted 48,774 antigen detection tests so far, out of which 1,345 have tested positive. Among those tested negative, 4,891 samples were taken for the confirmatory RT-PCR test, of which 550 were confirmed to be Covid-19 positive. The rapid antigen detection tests that began in the city on June 24, is mainly being conducted in the containment zones and the large outbreak regions (LORs) of the city. The antigen detection test looks for the toxin or the foreign substance in the body that triggers an immune response. It is helpful in quickly detecting and isolating infected patients.
“Apart from conducting tests in camps, the UPHCs will now have the facility to conduct the rapid antigen tests. Earlier, UPHCs were only permitted to collect samples for RT-PCR from 9am to 2pm daily for residents who are suspicious of the SARS-CoV-2 virus symptoms and want to get tested without any hassle. Antigen tests will now be allowed in all the 19 UPHCs during the same time slot,” said Dr Virender Yadav, chief medical officer (CMO), Gurugram.
For this, the health department has distributed 100 kits to each UPHC. “ These kits will be used only for symptomatic patients and high-risk contacts of an already confirmed case. Those getting tested for antigen detection will have to show proper identification,” said Yadav. To test high-risk contacts of confirmed Covid-19 patients, teams at the UPHCs will use their respective data bases of all confirmed cases.
“The Rapid Response Team (RRT) at the local level are aware of the people in the community. They are working with a population size of 1,000 to 2,000, which helps them in tracing the high-risk contacts. Based on their know- how about the community, these kits will be utilised,” said Dr Jai Prakash Sharma, district surveillance officer.
Over the last one month, efforts have been made to strengthen the UPHCs to deliver better outcomes in tackling the pandemic. All the UPHCs are required to update on a daily basis the list of people in their areas whose samples are being collected for the RT-PCR test, their contacts, and those who are being tested positive.
Importance of primary health centres
Experts are of the opinion that primary health centres are critical in handling infectious diseases as they are the first point of care for people. The functioning of such primary health centres was earlier restricted to only a few areas of healthcare, namely antenatal care, child birth, neonatal and infant healthcare, childhood and adolescent healthcare, family planning, usage of contraceptives and other areas of reproductive health..
The 2017 National Health Policy recommended establishment of PHCs as health and wellness centres. The range of services were expanded to include management of infectious, communicable and non-communicable diseases along with care for the elderly, palliative health care, and mental health issues.
Dr K Srinath Reddy, president, Public Health Foundation of India ( PHFI) said, “In an epidemic, PHCs have a critical role to play. Nearly 80% of the infections can be addressed at the PHC-level, where based on the screening alone, early diagnosis of the patient can be done. Early detection, testing and surveillance are possible at the local level. Although RT-PCR is the gold standard for frontline testing for Covid-19, arrangements for antigen testing at primary would help in identifying a higher number of high-risk cases.”
Calling it a positive move, K Sujatha Rao, former secretary, union ministry of health and family welfare, who is also the former director general, National AIDS Control Organisation (NACO) said, “During the time, when HIV was widely prevalent in the country, HIV-ELISA (Enzyme - Linked Immunosorbent Assay) test was being conducted at the PHC level to identify patients. Diagnosis at the primary level helps in preventing morbidity and mortality.”
According to Rao, for Covid-19 antigen testing, the team at the local level should to be careful of false negatives as antigen tests have a higher percentage of false negatives. “If 100 people are tested for antigen and 70 are negative, then it is important to figure out how many should be tested for RT-PCR. This is because, there are chances of missing out an infected person,” said Rao.