The Effect of Lateral Flow Urine Lipoarabinomannan Assay Online Blended Training on the Utilisation of Point-Of-Care Tuberculosis Testing in Kajiado, Kiambu, and Machakos Counties, Kenya

Abstract

The Background: Tuberculosis (TB) remains one of the leading causes of mortality globally, with Africa accounting for nearly half of global TB-related deaths. Despite being both preventable and treatable, TB continues to disproportionately affect people living with HIV. Objective: The study aimed to assess the effect of the lateral flow urine lipoarabinomannan assay (LF-LAM online blended Continuing Professional Development (CPD) on the utilisation of LF-LAM point-of-care TB testing. Methodology: This quasi-experimental study included a sample of Primary Healthcare Workers (PHCWs) who completed CPD training in Kajiado, Kiambu, and Machakos counties between March 10, 2025, and August 30, 2025. The analysis involved pre-and post-intervention comparative analysis. Results: A total of 333 PHCWs responded to the survey, with notably high representation of females (51%) and laboratory officers (59%). Overall mean scores for LF-LAM test knowledge and skills were statistically significant in three domains: Active Case Findings (p = 0.045), Biosafety in LF-LAM testing (p = 0.023), and data Reporting (p = 0.012). Test coverage among presumptive TB patients improved significantly, with 20.5% tested at pre-intervention compared to the LF-LAM positivity rate, which declined from 64.9% to 37.7% (rate ratio = 0.58, 95% CI 0.50–0.68, p < 0.001). The number of positives detected per 1,000 PLHIV screened increased from 4.34 to 6.40. Conclusion: The findings revealed favourable change regarding the CPD training program, demonstrating a positive impact on enhancing LF-LAM testing knowledge and competencies among health workers in primary healthcare settings. The observed improvements in TB indicators, including increased active case finding and greater uptake of point-of-care TB testing among people living with HIV (PLHIV), highlight the program’s potential to strengthen TB-HIV co-management at the primary care level. To sustain and scale these outcomes, continued mentorship, assurance of commodity security, and integration of LF-LAM testing within broader TB-HIV service delivery pathways are essential.