Comparative Effectiveness of Point-of-Care Viral Hepatitis Testing Versus Laboratory-Based Testing in Rural Kogi State

Point-of-care (POC) viral hepatitis testing offers potential advantages in reaching rural populations where laboratory infrastructure is absent, but its diagnostic accuracy and programme integration outcomes in rural Nigerian contexts are rarely compared against laboratory-based testing in controlled study designs. This study compares the sensitivity, specificity, and clinical impact of POC hepatitis B and C testing versus conventional laboratory ELISA in rural communities of Kogi State, North Central Nigeria. A diagnostic accuracy study will be conducted across 20 rural communities in Lokoja, Ofu, and Igalamela-Odolu local government areas. Community members aged 18 to 60 years will undergo paired testing: rapid immunochromatographic POC assays (SD Bioline HBsAg and anti-HCV) and reference ELISA performed on the same blood sample at the Federal Medical Centre Lokoja laboratory. Sensitivity, specificity, positive predictive value, and negative predictive value will be calculated using ELISA as the reference standard, stratified by HBsAg and HCV. Additionally, linkage to care rates of POC-reactive individuals versus ELISA-reactive individuals will be compared over a six-month follow-up. The added value of this study lies in its simultaneous assessment of diagnostic accuracy and care linkage outcomes, addressing both technical and programmatic questions on POC hepatitis testing in a rural North Central setting. Keywords: point-of-care testing, viral hepatitis, rural communities, Kogi State, diagnostic accuracy