RISE (RDT Implementation Strategy and Evaluation) Project

Support: Gavi

Partners: Johns Hopkins University

Status: On-going

Objective: The objective of this project is to identify and evaluate strategies to improve the effective use of cholera rapid diagnostic tests (RDTs) that will, in turn, enhance the effective use of oral cholera vaccine (OCV). Additionally, the project aims to evaluate the use of RDTs to address critical questions regarding the deployment of RDTs and strategies for their use, ultimately improving their effectiveness towards cholera control and elimination.

Current Outcomes: In 2023, the project supported Epidemiology and Disease Control Division (EDCD) in distributing cholera RDTs to 103 EWARS sites and assisted in the development of Standard Operating Procedures (SOP),Global Task Force on Cholera Control (GTFCC) job flyer, RDT interpretation guide (flyer), and Cholera RDTs Method Flow Chart, all of which were distributed along with the RDT kits. Nine qualitative interviews were conducted with physicians, laboratory personnel, and stakeholders from the National Public Health Laboratory (NPHL), EDCD, and the Department of Health Services to assess experiences with RDT distribution strategies used in the RISE study.

In 2024, the project supported EDCD in the Gavi application for receiving 43,600 cholera RDTs and facilitated their customs clearance. Additionally, the project supported the preparation of SOP and algorithm (flowchart) for RDT-based cholera surveillance. Forty in-depth interviews were conducted with representatives from EDCD, NPHL, and Province Public Health Laboratories (PPHL), along with physicians, laboratory personnel, and medical recorders at 12 health facilities in Kathmandu Valley. The project also carried out 48 clinical and laboratory vignettes to assess the quality of RDT usage and reporting at those 12 health facilities. In 2025, 85 facility surveys were conducted through phone call with clinicians and lab personnel of 85 EWARS health facilities following the cholera season.

Surveys were also completed with 7 PPHL representatives and 10 government officials.